| NPI | 1063401198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID G MOLL CEO 503-491-0117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OR 002102) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR 8305) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2008-10-21 |