| NPI | 1912064478 |
|---|---|
| Doing Business As | MAPLE STREET CLINIC PHARMACY |
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER VORRATH Pres 503-357-7552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: OR RP0000674CS) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2008-06-23 |