Siskiyou Community Health Center Pharmacy

LBN: Siskiyou Community Health Center Pharmacy
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 only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Siskiyou Community Health Center Pharmacy can be contacted via phone (541) 471-3455, 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) 471-3455
Fax: (541) 471-9242
Website:
Map and Directions
Authorized official contact:
Name: Booth, Richard
Phone: (541) 471-3455

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X RP-0002572-CS Oregon

Profile Details

NPI number 1881049658
LBN Legal business name Siskiyou Community Health Center Pharmacy
DBA Doing business as
Authorized official Booth, Richard
Entity Organization
Organization subpart 1 Yes
Enumeration date Apr 29th, 2016
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 1881049658 NPPES
Oregon MEDICAID 500711967

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