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General NPI Number Information
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NPI Number | 1205132560
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Entity Type | Organization
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Legal Business Name | MERIDIAN PHARMACY LLC
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Dates
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Enumeration Date | 02/04/2011
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Last Update Date | 05/28/2015
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Provider Practice Location Address
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Address Line | 11011 MERIDIAN AVE N STE 100
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City | SEATTLE
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State | WA
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Zip | 98133-8967
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Country | US
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Telephone | 206-403-1137
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Fax | 206-403-1253
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Provider Business Mailing Address
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Address Line | 11011 MERIDIAN AVE N STE 100
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City | SEATTLE
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State | WA
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Zip | 98133-8967
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Country | US
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Telephone | 206-403-1137
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Fax | 206-403-1253
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | ANNIE BUI
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Credential | PHARMD
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Telephone | 206-403-1137
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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 | PHARCF60205518
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License Number State | WA
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