Provider Demographics
NPI:1396594875
Name:MULTICARE HEALTH SYSTEM
Entity type:Organization
Organization Name:MULTICARE HEALTH SYSTEM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AVP AMBULATORY PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:HARBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-426-6209
Mailing Address - Street 1:PO BOX 5229 MS 315-C2-RXA
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98415-0229
Mailing Address - Country:US
Mailing Address - Phone:509-530-5390
Mailing Address - Fax:509-530-5399
Practice Address - Street 1:910 W 5TH AVE STE 270
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2977
Practice Address - Country:US
Practice Address - Phone:509-530-5390
Practice Address - Fax:509-530-5399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-16
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPHAR.CF.61582314OtherWA PQAC
WA2327457Medicaid