Provider Demographics
NPI:1821332347
Name:WSM BELVEDERE INC
Entity Type:Organization
Organization Name:WSM BELVEDERE INC
Other - Org Name:COMPOUNDING ALTERNATIVES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:HERBERT
Authorized Official - Last Name:MCNARY
Authorized Official - Suffix:III
Authorized Official - Credentials:RPH
Authorized Official - Phone:206-402-3078
Mailing Address - Street 1:8830 ROOSEVELT WAY NE
Mailing Address - Street 2:SUITE B
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115
Mailing Address - Country:US
Mailing Address - Phone:206-402-3078
Mailing Address - Fax:
Practice Address - Street 1:8830 ROOSEVELT WAY NE
Practice Address - Street 2:SUITE B
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-3042
Practice Address - Country:US
Practice Address - Phone:206-402-3078
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACF.60273364333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy