MEDICARE: SOAS, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261Q00000X	Clinic/Center
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
3	332B00000X	Durable Medical Equipment & Medical Supplies
4	333600000X	Pharmacy
5	3336L0003X	Long Term Care Pharmacy
6	3336S0011X	Specialty Pharmacy
7	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4931312	OTHER	WA	NCPDP NUMBER
2	CF00058260	OTHER	WA	STATE PHARMACY LICENSE
3	0195560	OTHER	WA	L&I
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336117597
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOAS, LLC

Provider Business Mailing Address
First Line	:	32170 STATE ROUTE 20
Second Line	:
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-3719
Country	:	US
Telephone Number	:	360-213-2236
Fax Number	:	360-213-2238

Provider Business Practice Location Address
First Line	:	8970 STATE ROUTE 525
Second Line	:
City	:	CLINTON
State	:	WA
Zip	:	98236
Country	:	US
Telephone Number	:	360-341-3885
Fax Number	:	360-341-3886

Authorized Official
Title or Position	:	OWNER/PHARMACIST
Name	:	MR. AARON M SYRING
Credential	:	PHARM.D.
Telephone Number	:	360-341-3885

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	08/11/2022

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Directions to “SOAS, LLC ” Practice Location

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