| NPI | 1922330828 |
|---|---|
| Doing Business As | PROVIDENCE BRIDGEPORT PHARMACY |
| Entity Type | Organization |
| Authorized Contact | REBECCA WILLIAMS Director, Financial Services 503-215-8584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OR RP-0002571-CS) |
| Enumeration Date | 2010-02-03 |
| Last Update Date | 2010-02-22 |