Provider Demographics
NPI:1528707411
Name:KAUR, MANINDER
Entity type:Individual
Prefix:
First Name:MANINDER
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1195 BOBLETT ST
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:WA
Mailing Address - Zip Code:98230-4062
Mailing Address - Country:US
Mailing Address - Phone:360-332-1616
Mailing Address - Fax:360-332-1336
Practice Address - Street 1:RITE AID
Practice Address - Street 2:1195 BOBLETT ST
Practice Address - City:BLAINE
Practice Address - State:WA
Practice Address - Zip Code:98230
Practice Address - Country:US
Practice Address - Phone:360-332-1616
Practice Address - Fax:360-332-1616
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183700000XPharmacy Service ProvidersPharmacy TechnicianGroup - Single Specialty