| NPI | 1124423793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICK R SCHEIDERMAN Sole Member 541-389-3671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: OR RP-0002988-CS) |
| Enumeration Date | 2014-10-25 |
| Last Update Date | 2014-10-25 |