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General NPI Number Information
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NPI Number | 1669483160
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Entity Type | Organization
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Legal Business Name | HIGHLAND HEALTH CARE LLC
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 01/14/2011
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Provider Practice Location Address
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Address Line | 22618 HWY 99 STE 109
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City | EDMONDS
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State | WA
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Zip | 98026-8395
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Country | US
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Telephone | 425-673-8533
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Fax | 425-673-5010
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Provider Business Mailing Address
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Address Line | 22618 HWY 99 STE 109
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City | EDMONDS
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State | WA
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Zip | 98026-8395
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Country | US
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Telephone | 425-673-8533
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Fax | 425-673-5010
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Authorized Official
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Title or Position | MANAGER
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Name | HYO KIM
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Credential |
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Telephone | 425-673-8533
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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 | 60190552
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License Number State | WA
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