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General NPI Number Information
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NPI Number | 1386195048
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Entity Type | Organization
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Legal Business Name | REDDI ENTERPRISES INC
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Dates
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Enumeration Date | 10/18/2016
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Last Update Date | 09/14/2017
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Provider Practice Location Address
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Address Line | 1412 SW 43RD ST 120
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City | RENTON
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State | WA
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Zip | 98057-4803
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Country | US
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Telephone | 425-251-6335
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Fax |
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Provider Business Mailing Address
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Address Line | 1412 SW 43RD ST SUITE 120
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City | RENTON
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State | WA
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Zip | 98057-4803
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Country | US
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Telephone | 425-251-6335
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | DR. ANDERSON JOLLY
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Credential | PHARMD
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Telephone | 425-251-6335
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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 | PHAR.CF.00058343
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License Number State | WA
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