Provider Demographics
NPI:1821126020
Name:ARLINGTON PHARMACY INC
Entity Type:Organization
Organization Name:ARLINGTON PHARMACY INC
Other - Org Name:ARLINGTON PHARMACY PRIME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CORY
Authorized Official - Middle Name:
Authorized Official - Last Name:DUSKIN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:360-435-7691
Mailing Address - Street 1:540 N WEST AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-1251
Mailing Address - Country:US
Mailing Address - Phone:360-435-5771
Mailing Address - Fax:360-435-2155
Practice Address - Street 1:9417 STATE AVE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-2205
Practice Address - Country:US
Practice Address - Phone:360-659-5919
Practice Address - Fax:360-651-8704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACF602711093336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2108270OtherPK
WA6028096Medicaid