| NPI | 1104666064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEROSE HINKLE Chief Financial Officer 541-256-4404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2024-05-29 |
| Last Update Date | 2024-10-17 |