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NPI Code Detail

MEDICARE: BRIGHAM R CONSOLIVER RPH

MEDICARE: BRIGHAM R CONSOLIVER RPH
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
1183500000XPharmacistPPH00017274WA

General Provider Information

NPI Number : 1922355072
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIGHAM R CONSOLIVER RPH
Provider Business Mailing Address
First Line : 123 MARY JO LN
Second Line :
City : SEQUIM
State : WA
Zip : 98382-6973
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 424 E 2ND ST
Second Line :
City : PORT ANGELES
State : WA
Zip : 98362-3119
Country : US
Telephone Number : 360-452-4200
Fax Number : 360-457-6557
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2012
Last Update Date : 08/08/2012

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Directions to “ BRIGHAM R CONSOLIVER RPH” Practice Location

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