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NPI 1043635022

NPI 1043635022 : RD LLC : WAPATO, WA

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General NPI Number Information
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    NPI Number           |    1043635022
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    Entity Type          |    Organization 
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    Legal Business Name  |    RD LLC 
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Dates
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    Enumeration Date     |    02/27/2014
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    Last Update Date     |    12/20/2025
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Provider Practice Location Address
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    Address Line         |    507 W 1ST ST 
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    City                 |    WAPATO
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    State                |    WA
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    Zip                  |    98951-1105
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    Country              |    US
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    Telephone            |    509-584-0300
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    Fax                  |    509-584-0302
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Provider Business Mailing Address
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    Address Line         |    PO BOX B 
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    City                 |    ILWACO
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    State                |    WA
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    Zip                  |    98624-0167
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     JEFFREY  HARRELL 
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    Credential           |    PHARMD
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    Telephone            |    360-859-8659
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    333600000X
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    Taxonomy Name        |    Pharmacy
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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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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