| Chinook Pharmacy Inc. | |
|
11 S Forks Ave Ste A Forks WA 98331-9006 | |
| (360) 374-2294 | |
| (360) 374-5057 |
| Full Name | Chinook Pharmacy Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 11 S Forks Ave Ste A, Forks, Washington |
| Authorized Official Name and Position | Charles Edward Carlson (OWNER/RPH) |
| Authorized Official Contact | 3603742294 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chinook Pharmacy Inc. Po Box 2136 Forks WA 98331-2136 Ph: (360) 374-2294 | Chinook Pharmacy Inc. 11 S Forks Ave Ste A Forks WA 98331-9006 Ph: (360) 374-2294 |
| NPI Number | 1417528282 |
|---|---|
| Provider Enumeration Date | 07/02/2021 |
| Last Update Date | 07/02/2021 |
| Certification Date | 07/02/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417528282 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
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