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General NPI Number Information
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NPI Number | 1023920105
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Entity Type | Organization
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Legal Business Name | PORT ORCHARD PHARMACY INC
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Dates
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Enumeration Date | 09/22/2026
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Last Update Date | 09/22/2026
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Provider Practice Location Address
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Address Line | 1786 SE MILE HILL DR
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City | PORT ORCHARD
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State | WA
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Zip | 98366-3512
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Country | US
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Telephone | 360-443-5144
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Fax | 360-443-5091
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Provider Business Mailing Address
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Address Line | 6417 83RD AVE W
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City | UNIVERSITY PLACE
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State | WA
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Zip | 98467-3902
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Country | US
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Telephone | 425-247-4108
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ANAND GOWDA
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Credential |
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Telephone | 425-247-4108
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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