| NPI | 1083732713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARTIY TAMAR BATSON Owner 503-521-0954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-08-22 |