Provider Demographics
NPI:1700440344
Name:QUINCY PHARMACY LLC
Entity type:Organization
Organization Name:QUINCY PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:APURVA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-851-0978
Mailing Address - Street 1:636 VALLEY MALL PKWY STE 7
Mailing Address - Street 2:
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-4898
Mailing Address - Country:US
Mailing Address - Phone:509-888-7797
Mailing Address - Fax:
Practice Address - Street 1:918 13TH AVE SW BLDG F
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:WA
Practice Address - Zip Code:98848-9811
Practice Address - Country:US
Practice Address - Phone:509-797-7676
Practice Address - Fax:509-797-7677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-29
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy