Overlake Medical Tower Pharmacy

LBN: Overlake Medical Tower Pharmacy
Overlake Medical Tower Pharmacy is an health care organization with primary practice located at 1135 116Th Ave Ne Ste 105, Bellevue WA 98004-4623. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Overlake Medical Tower Pharmacy can be contacted via phone (425) 688-5958, or through Lee, Annie via phone (425) 688-5958.

Contact Information

Primary practice address
1135 116Th Ave Ne Ste 105 Bellevue WA 98004-4623
Fax: (425) 467-3540
Website:
Authorized official contact:
Name: Lee, Annie PHD

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X CF00056713 Washington

Profile Details

NPI number 1043437890
LBN Legal business name Overlake Medical Tower Pharmacy
DBA Doing business as
Authorized official Lee, Annie PHD
Entity Organization
Organization subpart 1 No
Enumeration date Apr 20th, 2007
Last updated Sep 13th, 2007 - about 17 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 1043437890 NPPES
Other 4928151 OTHER ID NUMBER
MEDICAID 6023584 OTHER ID NUMBER

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