Provider Demographics
NPI:1669483160
Name:HIGHLAND HEALTH CARE LLC
Entity Type:Organization
Organization Name:HIGHLAND HEALTH CARE LLC
Other - Org Name:HIGHLAND PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HYO
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-673-8533
Mailing Address - Street 1:22618 HWY 99
Mailing Address - Street 2:STE 109
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-8395
Mailing Address - Country:US
Mailing Address - Phone:425-673-8533
Mailing Address - Fax:425-673-5010
Practice Address - Street 1:22618 HWY 99
Practice Address - Street 2:STE 109
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-8395
Practice Address - Country:US
Practice Address - Phone:425-673-8533
Practice Address - Fax:425-673-5010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA601905523336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4920232OtherNCPDP PROVIDER IDENTIFICATION NUMBER