Rogue Valley Manor Pharmacy

LBN: Rogue Valley Manor
Rogue Valley Manor Pharmacy is an health care organization with primary practice located at 1250 Mira Mar Ave , Medford OR 97504-5520. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Institutional Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Rogue Valley Manor can be contacted via phone (541) 857-7361, or through Millan, Fred via phone (541) 857-7361.

Contact Information

Primary practice address
1250 Mira Mar Ave Medford OR 97504-5520
Fax: (541) 857-7362
Website:
Authorized official contact:
Name: Millan, Fred RPH

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X RP0000882 Oregon
Suppliers / Institutional Pharmacy 3336I0012X
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1265572150
LBN Legal business name Rogue Valley Manor
DBA Doing business as Rogue Valley Manor Pharmacy
Authorized official Millan, Fred RPH
Entity Organization
Organization subpart 1 No
Enumeration date Feb 8th, 2007
Last updated Apr 11th, 2016 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265572150 NPPES
Other 2078260 PK
MEDICAID 385250 PK

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