Provider Information for 1285729012
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NEILS PHARMACY INC
Other Names:Doing Business As:NEILS PHARMACYOrganization Subpart: NO
NPI: 1285729012
Last Updated: 2010-10-05
Certification Date:
Certification Date:
Details
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NPI | 1285729012 | ||||||||
Enumeration Date | 2006-10-04 | ||||||||
NPI Type | NPI-2 Organization | ||||||||
Status | Active | ||||||||
Authorized Official Information | Name: Mr. ALBERT C LEGAULT Title: Owner/President Phone: 3604263327 | ||||||||
Mailing Address | 512 WEST FRANKLIN SHELTON, WA 98584 United States Phone: 360-426-3327 | Fax:360-427-5223 | ||||||||
Primary Practice Address | 512 WEST FRANKLIN SHELTON, WA 98584 United States Phone: 360-426-3327 | Fax:360-427-5223 | ||||||||
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