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General NPI Number Information
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NPI Number | 1659446235
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Entity Type | Organization
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Legal Business Name | SARATOGA ENTERPRISES INC
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 10/05/2011
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Provider Practice Location Address
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Address Line | 40 N MAIN ST
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City | COUPEVILLE
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State | WA
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Zip | 98239-9556
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Country | US
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Telephone | 360-678-4010
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Fax | 360-678-2075
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Provider Business Mailing Address
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Address Line | PO BOX 70
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City | COUPEVILLE
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State | WA
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Zip | 98239-0070
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Country | US
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Telephone | 360-678-4010
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Fax |
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | KATHERINE STALLMAN
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Credential | BSPHARM
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Telephone | 360-221-0211
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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 | CF00057687
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License Number State | WA
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Taxonomy #3
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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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