| NPI | 1386034312 |
|---|---|
| Doing Business As | PROVIDENCE PORTLAND MEDICAL CENTER PHARMACY |
| Entity Type | Organization |
| Authorized Contact | TAVIS SMITH Operations Manager 503-215-6296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OR RP-0000780) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2015-01-29 |
| Last Update Date | 2015-01-29 |