Provider Demographics
NPI:1699094417
Name:DARVIC ASSOC. INC.
Entity type:Organization
Organization Name:DARVIC ASSOC. INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:DEGARMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-709-9999
Mailing Address - Street 1:1907 HARRISON AVE NW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-5118
Mailing Address - Country:US
Mailing Address - Phone:360-709-9999
Mailing Address - Fax:360-705-2869
Practice Address - Street 1:1907 HARRISON AVE NW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-5118
Practice Address - Country:US
Practice Address - Phone:360-709-9999
Practice Address - Fax:360-705-2869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-18
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA572413336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy