| NPI | 1083160147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN CLARK Rph 541-660-7657 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OR 0015445) |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2016-08-29 |