1467824094 NPI number — MULTICARE HEALTH SYSTEMS

Table of content: (NPI 1467824094)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467824094 NPI number — MULTICARE HEALTH SYSTEMS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MULTICARE HEALTH SYSTEMS
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 AUBURN MEDICAL CENTER PHARMACY
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:
1467824094
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/27/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
315 MARTIN LUTHER KING JR WAY
Provider Second Line Business Mailing Address:
MS 315-C2-RX
Provider Business Mailing Address City Name:
TACOMA
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98405-4234
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-403-1078
Provider Business Mailing Address Fax Number:
253-403-1558

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
202 N DIVISION ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98001-4939
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-333-2450
Provider Business Practice Location Address Fax Number:
253-804-2869
Provider Enumeration Date:
10/22/2015

Additional Information

Authorized Official

Authorized Official Last Name:
TRAN
Authorized Official First Name:
HIEN
Authorized Official Middle Name:
Authorized Official Title or Position:
SUPERVISOR
Authorized Official Telephone Number:
253-403-3687

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , with the licence number:  PHAR.CF.60307804-HOS , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336C0004X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336I0012X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 2154685 . This is a "PK" identifier . This identifiers is of the category "OTHER".




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