| NPI | 1902161946 |
|---|---|
| Former Legal Business Name | OREGON RETINA |
| Entity Type | Organization |
| Authorized Contact | ALBERT O EDWARDS Owner/Physician 541-762-2763 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| 3336C0002X Pharmacy, Clinic Pharmacy | |
| 261QS0132X Clinic/Center, Ophthalmologic Surgery | |
| 207WX0107X Ophthalmology, Retina Specialist | |
| 261QR1100X Clinic/Center, Research | |
| 261QM2500X Clinic/Center, Medical Specialty | |
| 152W00000X Optometrist | |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2023-12-19 |