Provider Demographics
NPI:1588359772
Name:FACTORIA PHARMACY
Entity type:Organization
Organization Name:FACTORIA PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:HANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUNG
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD,RPH
Authorized Official - Phone:206-397-2299
Mailing Address - Street 1:1425 WESTERN AVE APT 310
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2036
Mailing Address - Country:US
Mailing Address - Phone:206-397-2299
Mailing Address - Fax:
Practice Address - Street 1:12816 SE 38TH ST STE D
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-1327
Practice Address - Country:US
Practice Address - Phone:425-590-9629
Practice Address - Fax:425-590-9604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-05
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy