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General NPI Number Information
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NPI Number | 1518444025
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Entity Type | Organization
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Legal Business Name | COLUMBIA PHARMACY
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Dates
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Enumeration Date | 07/26/2018
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Last Update Date | 07/26/2018
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Provider Practice Location Address
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Address Line | 2700 NE ANDRESEN RD STE E3
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City | VANCOUVER
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State | WA
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Zip | 98661
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Country | US
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Telephone | 855-900-1515
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Fax |
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Provider Business Mailing Address
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Address Line | 2700 NE ANDRESEN RD STE E3
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City | VANCOUVER
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State | WA
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Zip | 98661-7344
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Country | US
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Telephone | 855-900-1515
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RYAN LANG
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Credential |
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Telephone | 503-705-4105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding 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 |
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License Number State |
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