# UMPQUA COMMUNITY HEALTH CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Aviva Health Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023747813
- **Authorized official:** KC BOLTON (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (541) 672-9596

## Contact information

- **Practice address:** 150 NE KENNETH FORD DR, ROSEBURG, OR 97470-1042
- **Practice address phone:** (541) 672-9596
- **Practice address fax:** (541) 492-2060
- **Mailing address:** 150 NE KENNETH FORD DR, ROSEBURG, OR 97470-1042
- **Mailing address phone:** (541) 672-9596
- **Mailing address fax:** (541) 492-2060

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 06/07/2022
- **Last updated:** 06/09/2022