Healthcare Provider Details

I. General information

NPI: 1548261068
Provider Name (Legal Business Name): BATES DRUG STORES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3704 N NEVADA ST
SPOKANE WA
99207-2968
US

IV. Provider business mailing address

3704 N NEVADA ST
SPOKANE WA
99207-2968
US

V. Phone/Fax

Practice location:
  • Phone: 509-489-4500
  • Fax: 509-489-4330
Mailing address:
  • Phone: 509-489-4500
  • Fax: 509-489-4330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberCF00057208
License Number StateWA

VIII. Authorized Official

Name: ROBERT THOMAS CORDIER
Title or Position: CEO
Credential:
Phone: 509-489-4500