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General NPI Number Information
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NPI Number | 1366872798
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Entity Type | Organization
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Legal Business Name | IPSEN PHARMACY SERVICES LLC
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Dates
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Enumeration Date | 11/21/2013
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Last Update Date | 11/04/2016
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Provider Practice Location Address
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Address Line | 700 AVENUE D SUITE 102
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City | SNOHOMISH
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State | WA
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Zip | 98290-2387
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Country | US
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Telephone | 360-568-7787
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Fax | 360-568-3626
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Provider Business Mailing Address
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Address Line | 700 AVENUE D STE 102
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City | SNOHOMISH
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State | WA
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Zip | 98290-2387
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Country | US
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Telephone | 360-568-7787
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Fax | 360-568-3626
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Authorized Official
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Title or Position | OWNER
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Name | DAWN IPSEN
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Credential |
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Telephone | 360-568-1297
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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 | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | 60434626
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License Number State | WA
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