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General NPI Number Information
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NPI Number | 1922215094
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Entity Type | Organization
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Legal Business Name | MIKES DRUGS
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8506 E. MILL PLAIN BLVD. SUITE B
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City | VANCOUVER
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State | WA
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Zip | 98664
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Country | US
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Telephone | 360-694-3354
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Fax |
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Provider Business Mailing Address
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Address Line | 8506 E. MILL PLAIN BLVD. SUITE B
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City | VANCOUVER
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State | WA
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Zip | 98664
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Country | US
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Telephone | 360-694-3354
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Fax |
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Authorized Official
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Title or Position | PRES
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Name | DR. MICHAEL GRAEFF
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Credential | P.D.
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Telephone | 360-694-3354
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number | CF00001931
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License Number State | WA
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