Healthcare Provider Details

I. General information

NPI: 1598701617
Provider Name (Legal Business Name): MULTICARE HEALTH SYSTEMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 09/29/2021
Certification Date: 09/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 S L ST
TACOMA WA
98405-3720
US

IV. Provider business mailing address

311 S L ST
TACOMA WA
98405-3720
US

V. Phone/Fax

Practice location:
  • Phone: 253-403-1411
  • Fax: 253-403-1745
Mailing address:
  • Phone: 253-403-1411
  • Fax: 253-403-1745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
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.60306875
License Number StateWA

VIII. Authorized Official

Name: TERESA DIANE HARBERG
Title or Position: DIRECTOR, AMBULATORY PHARMACY
Credential: PHARMD
Phone: 253-426-6209