Organization · NPI-2

1918 Winter Street Operating Co LLC

Pharmacy, Community/Retail Pharmacy · Mount Vernon, WA

NPI number1407627995
StatusActive
Last updated in NPPESJul 24, 2024

Details

NPI
1407627995
Entity type
Organization (NPI-2)
Legal business name
1918 Winter Street Operating Co LLC
Organization subpart
No
Enumeration date
Jan 12, 2024
Certification date
Jan 9, 2024
Last updated
Jul 24, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3336C0003X Pharmacy, Community/Retail Pharmacy––Yes
332B00000X Durable Medical Equipment & Medical Supplies––

Other names

  • Safeway Pharmacy #1472 (Doing Business As)

Practice location

315 E College Way
Mount Vernon, WA 98273-5431

Phone 360-424-0467 · Fax 360-424-0427

Mailing address

7 Corporate Dr
Keene, NH 03431-5042

Phone 603-354-7000

Authorized official

Kevin Mcnamara
Authorized Person
6033544619

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