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 260, Liberty Lake WA 99019-9687. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Halcyon Rx Inc can be contacted via phone (509) 255-7611, or through Amini, John via phone (509) 255-7611.

Contact Information

Primary practice address
23801 E Appleway Ave Ste 260 Liberty Lake WA 99019-9687
Phone: (509) 255-7611
Fax: (509) 755-3337
Website:
Map and Directions
Authorized official contact:
Name: Amini, John RPH
Phone: (509) 255-7611

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHAR.CF.00059100 Washington
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1841387750
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 Oct 10th, 2006
Last updated Nov 27th, 2012 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841387750 NPPES
Other 4928593 NCPDP PROVIDER IDENTIFICATION NUMBER

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