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General NPI Number Information
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NPI Number | 1356755631
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Entity Type | Organization
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Legal Business Name | RIDGE PHARMACY
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Dates
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Enumeration Date | 06/16/2014
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Last Update Date | 03/01/2017
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Provider Practice Location Address
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Address Line | 7730 CENTER BLVD SE
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City | SNOQUALMIE
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State | WA
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Zip | 98065-8743
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Country | US
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Telephone | 425-363-2960
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Fax | 425-363-2961
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Provider Business Mailing Address
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Address Line | 1305 MADISON ST
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City | SEATTLE
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State | WA
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Zip | 98104-3507
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Country | US
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Telephone | 206-382-2087
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Fax | 206-382-4342
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Authorized Official
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Title or Position | PRESIDENT
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Name | DARREN AUGENSTEIN
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Credential |
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Telephone | 425-363-2960
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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 | PHARCF60472817
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License Number State | WA
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