Medicine Man Liberty Lake
LBN: Halcyon Rx Inc
Medicine Man Liberty Lake is an health care organization with primary practice located at 23801 E Appleway Ave Ste 260B, Liberty Lake WA 99019-9687. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Compounding Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Long Term Care Pharmacy is the primary health care specialty.
Halcyon Rx Inc can be contacted via phone (509) 755-3333, or through Amini, John via phone (509) 755-3333.
Contact Information
Primary practice address
23801 E Appleway Ave Ste 260B
Liberty Lake WA 99019-9687
Phone: (509) 755-3333
Fax: (509) 755-3337
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | FL0341254 | Washington |
| Suppliers / Compounding Pharmacy | 3336C0004X | FL0341254 | Washington |
| Suppliers / Long Term Care Pharmacy | 3336L0003X | FL0341254 | Washington |
Profile Details
| NPI number | 1326142373 |
|---|---|
| LBN Legal business name | Halcyon Rx Inc |
| DBA Doing business as | Medicine Man Liberty Lake |
| Authorized official | Amini, John RPH |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 12th, 2006 |
| Last updated | Feb 12th, 2008 - about 16 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1326142373 | NPPES |
| Washington | MEDICAID | 6024178 | |
| Washington | Other | 4931463 |
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