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General NPI Number Information
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NPI Number | 1174681019
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Entity Type | Organization
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Legal Business Name | CROWN DRUG OF HOQUIAM INC
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 02/21/2008
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Provider Practice Location Address
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Address Line | 2544 SIMPSON AVE
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City | HOQUIAM
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State | WA
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Zip | 98550-3937
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Country | US
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Telephone | 360-533-0961
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Fax | 360-532-8997
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Provider Business Mailing Address
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Address Line | 2544 SIMPSON AVE
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City | HOQUIAM
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State | WA
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Zip | 98550-3937
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Country | US
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Telephone | 360-533-0961
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Fax | 360-532-8997
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GREG A GRUN
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Credential | RPH
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Telephone | 360-533-0961
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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 | CF00001373
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License Number State | WA
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