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General NPI Number Information
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NPI Number | 1154319572
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Entity Type | Organization
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Legal Business Name | ROSAUERS SUPERMARKETS INC
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Dates
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Enumeration Date | 10/10/2005
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Last Update Date | 09/13/2007
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Provider Practice Location Address
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Address Line | 1250 N HIGHWAY 395
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City | COLVILLE
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State | WA
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Zip | 99114-2005
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Country | US
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Telephone | 509-684-3151
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Fax | 509-684-3233
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Provider Business Mailing Address
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Address Line | PO BOX 9000 1815 W GARLAND
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City | SPOKANE
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State | WA
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Zip | 99209-9000
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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 | PRES
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Name | JEFFRY PHILIPPS
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Credential | RPH
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Telephone | 509-326-8900
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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 | CF56023
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License Number State | WA
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