Dia, Oliver Custodio
Dia, Oliver Custodio is an individual health care provider with primary practice located at 9040 A Jackson Ave , Tacoma WA 98431-0001. He recently has 2 registered licenses in different health care specialties including Pharmacy Service Providers / Pharmacist, Pharmacy Service Providers / Ambulatory Care. Pharmacy Service Providers / Ambulatory Care is his primary health care specialty. Dia, Oliver Custodio can be contacted via phone (253) 968-2586.Contact Information
Primary practice address
9040 A Jackson Ave
Tacoma WA 98431-0001
Phone: (253) 968-2586
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Pharmacy Service Providers / Pharmacist | 183500000X | RPH50999 | Washington |
Pharmacy Service Providers / Pharmacist | 183500000X | RPH44850 | California |
Pharmacy Service Providers / Ambulatory Care | 1835P2201X | WA50999 | Washington |
Profile Details
NPI number | 1558873190 |
---|---|
LBN Legal business name | Dia, Oliver Custodio |
Credentials | RPH |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Nov 3rd, 2017 |
Last updated | Jun 16th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1558873190 | NPPES |
Washington | Other | RPH50999 | REGISTERED PHARMACIST |
Washington | Other | RPH44850 | REGISTERED PHARMACIST |
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