Provider Demographics
NPI:1346793874
Name:MULTICARE HEALTH SYSTEM
Entity Type:Organization
Organization Name:MULTICARE HEALTH SYSTEM
Other - Org Name:MULTICARE HOME INFUSION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AVP AMBULATORY PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:HARBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-403-2283
Mailing Address - Street 1:P.O. BOX 5299
Mailing Address - Street 2:MS: 820-5-PCO
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98415-0299
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1901 SOUTH UNION ST
Practice Address - Street 2:SUITE #3009
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405
Practice Address - Country:US
Practice Address - Phone:253-459-6650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-02
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 333600000X, 3336S0011X
WAPHAR.CF.000562433336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Yes333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPHARM.CF.00056243OtherPHARMACY LICENSE