| NPI | 1144343914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGG A WENDLAND Pharmacy Manager 541-346-4454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 261QS1000X Clinic/Center Student Health (Licence: OR RP-0000196-CS) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2022-01-03 |