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Organization
UMPQUA COMMUNITY HEALTH CENTER, INC.
Active
Organization
UMPQUA COMMUNITY HEALTH CENTER, INC.
Active
Other names
Aviva Health Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KC BOLTON (CHIEF EXECUTIVE OFFICER)
(541) 672-9596
Entity
Organization
Contact information
Practice address
150 NE KENNETH FORD DR, ROSEBURG, OR 97470-1042
(541) 672-9596
(541) 492-2060
Mailing address
150 NE KENNETH FORD DR, ROSEBURG, OR 97470-1042
(541) 672-9596
(541) 492-2060
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
Other
Enumeration date
06/07/2022
Last updated
06/09/2022
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