Dia, Oliver Custodio

Dia, Oliver Custodio is an individual health care provider with primary practice located at 9040 A Jackson Ave , Tacoma WA 98431-0001. He recently has 2 registered licenses in different health care specialties including Pharmacy Service Providers / Pharmacist, Pharmacy Service Providers / Ambulatory Care. Pharmacy Service Providers / Ambulatory Care is his primary health care specialty. Dia, Oliver Custodio can be contacted via phone (253) 968-2586.

Contact Information

Primary practice address
9040 A Jackson Ave Tacoma WA 98431-0001
Phone: (253) 968-2586
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X RPH50999 Washington
Pharmacy Service Providers / Pharmacist 183500000X RPH44850 California
Pharmacy Service Providers / Ambulatory Care 1835P2201X WA50999 Washington

Profile Details

NPI number 1558873190
LBN Legal business name Dia, Oliver Custodio
Credentials RPH
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 3rd, 2017
Last updated Jun 16th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558873190 NPPES
Washington Other RPH50999 REGISTERED PHARMACIST
Washington Other RPH44850 REGISTERED PHARMACIST

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