Provider Demographics
NPI:1841581964
Name:MAKERS PHARMACY
Entity Type:Organization
Organization Name:MAKERS PHARMACY
Other - Org Name:MAKERS COMPOUNDING PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:KILLMER
Authorized Official - Last Name:MOSER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:360-757-6677
Mailing Address - Street 1:839 S BURLINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98233-3307
Mailing Address - Country:US
Mailing Address - Phone:360-757-6677
Mailing Address - Fax:360-757-6888
Practice Address - Street 1:839 S BURLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98233-3307
Practice Address - Country:US
Practice Address - Phone:360-757-6677
Practice Address - Fax:360-757-6888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-23
Last Update Date:2011-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60217314261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service