1346793874 NPI number — MULTICARE HEALTH SYSTEM

Table of content: (NPI 1346793874)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346793874 NPI number — MULTICARE HEALTH SYSTEM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MULTICARE HEALTH SYSTEM
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MULTICARE HOME INFUSION
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346793874
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/20/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 5299
Provider Second Line Business Mailing Address:
MS: 820-5-PCO
Provider Business Mailing Address City Name:
TACOMA
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98415-0299
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1901 SOUTH UNION ST
Provider Second Line Business Practice Location Address:
SUITE #3009
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-459-6650
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/02/2016

Additional Information

Authorized Official

Authorized Official Last Name:
HARBERG
Authorized Official First Name:
TERESA
Authorized Official Middle Name:
DIANE
Authorized Official Title or Position:
AVP AMBULATORY PHARMACY
Authorized Official Telephone Number:
253-403-2283

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: PHARM.CF.00056243 . This is a "PHARMACY LICENSE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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