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General NPI Number Information
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NPI Number | 1619205267
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Entity Type | Organization
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Legal Business Name | PUGET SOUND PHARMACY LLC
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Dates
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Enumeration Date | 11/19/2009
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Last Update Date | 08/30/2011
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Provider Practice Location Address
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Address Line | 1112 6TH AVE STE 101
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City | TACOMA
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State | WA
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Zip | 98405-4048
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Country | US
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Telephone | 253-572-0180
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Fax | 253-561-0018
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Provider Business Mailing Address
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Address Line | 1112 6TH AVE STE 101
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City | TACOMA
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State | WA
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Zip | 98405-4040
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Country | US
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Telephone | 253-572-0180
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Fax | 253-561-0018
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Authorized Official
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Title or Position | MANAGER
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Name | DR. ROSALIE NGUYEN
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Credential | PHARMD
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Telephone | 253-572-0180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic 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 | 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 #3
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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 #4
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | CF60114820
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License Number State | WA
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