Siskiyou Community Health Center Pharmacy

LBN: Siskiyou Community Health Center, Inc
Siskiyou Community Health Center Pharmacy is an health care organization with primary practice located at 1701 Nw Hawthorne Ave , Grants Pass OR 97526-1257. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Clinic Pharmacy. Suppliers / Clinic Pharmacy is the primary health care specialty. Siskiyou Community Health Center, Inc can be contacted via phone (541) 472-4747, or through Booth, Richard via phone (541) 471-3455.

Contact Information

Primary practice address
1701 Nw Hawthorne Ave Grants Pass OR 97526-1257
Phone: (541) 472-4747
Fax: (541) 472-4786
Website:
Map and Directions
Authorized official contact:
Name: Booth, Richard
Phone: (541) 471-3455

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Clinic Pharmacy 3336C0002X RP0002572CS Oregon

Profile Details

NPI number 1831425164
LBN Legal business name Siskiyou Community Health Center, Inc
DBA Doing business as Siskiyou Community Health Center Pharmacy
Authorized official Booth, Richard
Entity Organization
Organization subpart 1 Yes
Enumeration date Oct 21st, 2009
Last updated Oct 6th, 2021 - about 3 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 1831425164 NPPES
Oregon MEDICAID 127725
Oregon MEDICAID 500614374
Oregon Other 2122472

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