Healthcare Provider Details

I. General information

NPI: 1063448744
Provider Name (Legal Business Name): RANIER HOME HEALTHCARE PHCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 07/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 METCALF ST
SEDRO WOOLLEY WA
98284-1423
US

IV. Provider business mailing address

810 METCALF ST
SEDRO WOOLLEY WA
98284-1423
US

V. Phone/Fax

Practice location:
  • Phone: 360-855-2800
  • Fax: 360-855-2888
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberFL00058091
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOHN TRAN
Title or Position: PRESIDENT
Credential:
Phone: 206-726-1118