NPI | 1780738138 |
---|---|
Doing Business As | BLACK OAK PHARMACY |
Entity Type | Organization |
Authorized Contact | TIMOTHY LICHLYTER President 541-773-5356 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OR RP-0000767) |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
3336C0004X Pharmacy, Compounding Pharmacy | |
333600000X Pharmacy | |
Enumeration Date | 2007-01-23 |
Last Update Date | 2013-08-26 |