MEDICARE: SPECIALTY PHARMACIES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy	CF00058164	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PHAR.CF.00058164	OTHER	WA	STATE LICENSE
2	4929595	OTHER		NCPDP PROVIDER ID
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255389961
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECIALTY PHARMACIES, INC.

Provider Business Mailing Address
First Line	:	1120 CHERRY ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98104-2044
Country	:	US
Telephone Number	:	206-624-1391
Fax Number	:	206-624-1791

Provider Business Practice Location Address
First Line	:	1120 CHERRY ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98104-2044
Country	:	US
Telephone Number	:	206-624-1391
Fax Number	:	206-624-1791

Authorized Official
Title or Position	:	SENIOR VICE PRESIDENT AND TREASURER
Name	:	RUSSELL J. FICHERA
Credential	:
Telephone Number	:	508-297-1018

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	03/07/2023

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Directions to “SPECIALTY PHARMACIES, INC. ” Practice Location

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