| NPI | 1790830446 |
|---|---|
| Doing Business As | SHADY COVE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY LICHLYTER President 541-494-2616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OR RP0000715CS) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2010-08-25 |