Provider Demographics
NPI: | 1275808214 |
---|---|
Name: | NEIGHBORCARE HEALTH |
Entity Type: | Organization |
Organization Name: | NEIGHBORCARE HEALTH |
Other - Org Name: | NEIGHBORCARE HEALTH AT BALLARD |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | CHIEF EXECUTIVE OFFICER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MICHAEL |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | ERIKSON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 206-461-6935 |
Mailing Address - Street 1: | 1200 12TH AVE S STE 901 |
Mailing Address - Street 2: | |
Mailing Address - City: | SEATTLE |
Mailing Address - State: | WA |
Mailing Address - Zip Code: | 98144-2712 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 206-548-3114 |
Mailing Address - Fax: | 206-762-6355 |
Practice Address - Street 1: | 1753 NW 56TH ST STE 200 |
Practice Address - Street 2: | |
Practice Address - City: | SEATTLE |
Practice Address - State: | WA |
Practice Address - Zip Code: | 98107-5279 |
Practice Address - Country: | US |
Practice Address - Phone: | 206-782-5939 |
Practice Address - Fax: | 206-782-5934 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2012-03-08 |
Last Update Date: | 2018-03-30 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Single Specialty |