Healthcare Provider Details

I. General information

NPI: 1396005294
Provider Name (Legal Business Name): MULTICARE HEALTH SYSTEMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2012
Last Update Date: 01/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2209 N PEARL ST STE 100
TACOMA WA
98406-2529
US

IV. Provider business mailing address

2209 N PEARL ST STE 100
TACOMA WA
98406-2529
US

V. Phone/Fax

Practice location:
  • Phone: 253-459-7144
  • Fax: 253-459-7143
Mailing address:
  • Phone: 253-447-3355
  • Fax: 253-447-3375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHAR.CF.60283641
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: HIEN TRAN
Title or Position: PHARMACY SUPERVISOR
Credential: PHARMD
Phone: 253-447-3355