Healthcare Provider Details

I. General information

NPI: 1164536025
Provider Name (Legal Business Name): MULTICARE HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 MARTIN LUTHER KING JR WAY MS: 315-C2-HIN
TACOMA WA
98405-4234
US

IV. Provider business mailing address

315 MLK JR WAY MS 315-C2-HIN PO BOX 5299 MS 315-C2-HIN
TACOMA WA
98415-0299
US

V. Phone/Fax

Practice location:
  • Phone: 253-403-2475
  • Fax: 253-403-1845
Mailing address:
  • Phone: 253-403-2475
  • Fax: 253-403-1845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License NumberPHAR.CF.00056243
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberIHS.FS.00000372
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License NumberBM6171588
License Number StateWA
# 5
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License NumberPHAR.CF.00056243
License Number StateWA

VIII. Authorized Official

Name: WILLIAM GLENN ROBERTSON
Title or Position: CEO
Credential:
Phone: 253-403-1272