| NPI | 1174838635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FORREST FENTRESS Pharmacist/President 541-431-7377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: OR RP0001584CS) |
| Enumeration Date | 2010-08-09 |
| Last Update Date | 2010-08-09 |