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General NPI Number Information
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NPI Number | 1366443921
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Entity Type | Organization
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Legal Business Name | VALU DRUG INC.
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Dates
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Enumeration Date | 08/04/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 201 E PIONEER AVE
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City | MONTESANO
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State | WA
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Zip | 98563-4514
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Country | US
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Telephone | 360-249-4444
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Fax |
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Provider Business Mailing Address
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Address Line | 201 E PIONEER AVE
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City | MONTESANO
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State | WA
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Zip | 98563-4514
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Country | US
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Telephone | 360-249-4444
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Fax |
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | MR. CHARLES MARK SAGEN
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Credential | RPH.
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Telephone | 360-249-4444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH00010594
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License Number State | WA
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