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General NPI Number Information
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NPI Number | 1992701155
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Entity Type | Organization
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Legal Business Name | WILLIAM R. COLEMAN
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | 301 S WAPATO AVE
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City | WAPATO
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State | WA
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Zip | 98951-1346
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Country | US
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Telephone | 509-877-2707
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Fax | 509-877-2577
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Provider Business Mailing Address
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Address Line | 301 S WAPATO AVE P.O. BOX 98
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City | WAPATO
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State | WA
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Zip | 98951-1346
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Country | US
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Telephone | 509-877-2707
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Fax | 509-877-2577
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Authorized Official
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Title or Position | OWNER
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Name | MR. WILLIAM RICHARD COLEMAN
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Credential | RPH
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Telephone | 509-877-2707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PH00009443
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License Number State | WA
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