Healthcare Provider Details

I. General information

NPI: 1922029990
Provider Name (Legal Business Name): RXTRA CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7317 35TH AVE NE
SEATTLE WA
98115-5918
US

IV. Provider business mailing address

7317 35TH AVE NE
SEATTLE WA
98115-5918
US

V. Phone/Fax

Practice location:
  • Phone: 206-417-8066
  • Fax: 206-417-8076
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberCF57811
License Number StateWA

VIII. Authorized Official

Name: HOLLIS HENRY
Title or Position: PRESIDENT
Credential:
Phone: 206-417-8066