Healthcare Provider Details

I. General information

NPI: 1720564925
Provider Name (Legal Business Name): ACTS PHARMACY AND HEALTHCARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2018
Last Update Date: 03/09/2022
Certification Date: 03/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 S UNION AVE BLDG B STE 2011
TACOMA WA
98405
US

IV. Provider business mailing address

1901 S UNION AVE BLDG B STE 2011
TACOMA WA
98405
US

V. Phone/Fax

Practice location:
  • Phone: 253-272-0324
  • Fax: 253-272-0490
Mailing address:
  • Phone: 253-272-0324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: JAZEL JANE MANONGDO BAUTISTA
Title or Position: GOVERNOR/PHARMACIST-IN-CHARGE
Credential: RPH
Phone: 253-306-0225