1918 Winter Street Operating Co LLC
NPI #1407627292 in Maple Valley, Washington
Provider Information
- NPI Number
- 1407627292
- Entity Type
- Organization
- Organization Name
- 1918 Winter Street Operating Co LLC
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- Jan 11, 2024
- Last Updated
- Jul 24, 2024
Practice Location
- Address
- 26916 MAPLE VALLEY BLACK DIAMOND RD SE
- City
- Maple Valley
- State
- Washington
- ZIP Code
- 98038-8322
- Phone
- (425) 432-3077
Authorized Official
- Name
- KEVIN MCNAMARA
- Title
- AUTHORIZED PERSON
- Phone
- (603) 354-4619
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
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