| NPI | 1659755593 |
|---|---|
| Doing Business As | PORTLAND PROFESSIONAL PHARMACY |
| Entity Type | Organization |
| Authorized Contact | SUSAN HODGE Manager 702-203-4797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OR RP-0003101-CS) |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2015-08-04 |