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General NPI Number Information
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NPI Number | 1992227375
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Entity Type | Organization
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Legal Business Name | CLB PHARMACEUTICAL RESOURCES INC
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Dates
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Enumeration Date | 07/07/2017
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Last Update Date | 07/07/2017
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Provider Practice Location Address
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Address Line | 22712 78TH ST. E
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City | BUCKLEY
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State | WA
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Zip | 98321
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Country | US
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Telephone | 253-239-3004
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Fax |
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Provider Business Mailing Address
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Address Line | 22712 78TH ST E
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City | BUCKLEY
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State | WA
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Zip | 98321-5105
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRINCIPLE
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Name | PAUL THOMPSON
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Credential | PHARMD
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Telephone | 253-239-3004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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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 | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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