| NPI | 1548313356 |
|---|---|
| Doing Business As | ELM STREET PHARMACY |
| Entity Type | Organization |
| Authorized Contact | DAVID TRIEBES CEO 541-812-4102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OR 00104) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2018-11-21 |