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General NPI Number Information
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NPI Number | 1992836092
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Entity Type | Organization
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Legal Business Name | PARK PHARMACY INC
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 06/06/2016
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Provider Practice Location Address
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Address Line | 401 NE RAVENNA BLVD
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City | SEATTLE
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State | WA
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Zip | 98115-8401
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Country | US
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Telephone | 206-527-3010
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Fax | 206-527-2320
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Provider Business Mailing Address
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Address Line | 401 NE RAVENNA BLVD
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City | SEATTLE
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State | WA
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Zip | 98115-8401
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Country | US
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Telephone | 206-527-3010
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Fax | 206-527-2320
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Authorized Official
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Title or Position | OWNER
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Name | JUNG IL PARK
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Credential | RPH
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Telephone | 206-527-3010
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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 |
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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 | CF00002044
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License Number State | WA
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