| NPI | 1730830365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOBBI JOLYNE SURPLUS Revenue Cycle Manager 541-408-9486 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2022-01-14 |
| Last Update Date | 2022-01-14 |