KSR Health Care LLC
Organization Active NPI Long Term Care Pharmacy · Sultan, WA
NPI 1316577869 · NPPES record last updated Jan 23, 2020
Key facts
- NPI
- 1316577869
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Long Term Care Pharmacy 3336L0003X
- Legal business name
- KSR HEALTH CARE LLC
- Practice address
- 507 W Stevens Ave Ste Aaa
Sultan, WA 98294-9515 - Phone
- (360) 953-5250
- NPI assigned
- Jan 23, 2020
- Organization subpart
- No
Authorized official
- Name
- Simeon Roth, PHARMD
- Title
- Ceo
- Phone
- (360) 953-5250
Corporate family (same tax ID) 2
National Provider Directory
- Tax ID family
- Invara
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | Yes |
Addresses
Primary practice location
507 W Stevens Ave Ste Aaa
Sultan, WA 98294-9515
Mailing address
PO Box 90
Sultan, WA 98294-0090
Phone (360) 953-5250
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2132773 | Medicaid | WA |
Other names
- Invara
Other providers in Sultan, WA
- Ruth Ann Hackenbracht
- Nicholas Hakiel
- Kathryn Isely
- Rebecca Kmitta
- KSR Health Care LLC
- KSR Health Care LLC
- Brandy Lipscomb
- Julie Ann Martinez
- Michele D Mayatte
- Dana Lynn McCarty
All providers in Sultan, WA · Long Term Care Pharmacy in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.