Provider Demographics
NPI:1528439775
Name:DOC PHARMACY SERVICES
Entity type:Organization
Organization Name:DOC PHARMACY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACTS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DARYL
Authorized Official - Middle Name:A
Authorized Official - Last Name:HUNTSINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:564-999-3950
Mailing Address - Street 1:20403 OLD HIGHWAY 9 SW
Mailing Address - Street 2:
Mailing Address - City:CENTRALIA
Mailing Address - State:WA
Mailing Address - Zip Code:98531-7915
Mailing Address - Country:US
Mailing Address - Phone:360-664-3400
Mailing Address - Fax:360-664-3410
Practice Address - Street 1:20403 OLD HIGHWAY 9 SW
Practice Address - Street 2:
Practice Address - City:CENTRALIA
Practice Address - State:WA
Practice Address - Zip Code:98531-7915
Practice Address - Country:US
Practice Address - Phone:360-664-3400
Practice Address - Fax:360-664-3410
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WASHINGTON DEPT OF CORRECTIONS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-14
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPHAR.CF.60488322333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy