# PHILIP KASER FAMILY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Harvard Avenue Drugs
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114456563
- **Authorized official:** JEANNIE E HOOTEN RPH (PIC, MANAGER)
- **Authorized official phone:** (541) 672-1961

## Contact information

- **Practice address:** 1175 W. HARVARD AVENUE, ROSEBURG, OR 97471
- **Practice address phone:** (541) 672-1961
- **Practice address fax:** (541) 672-9314
- **Mailing address:** 1175 W HARVARD AVE, ROSEBURG, OR 97471-2834
- **Mailing address phone:** (541) 672-1961
- **Mailing address fax:** (541) 672-9314

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | RP-0000491-CS | OR | Yes |

## Other

- **Enumeration date:** 06/08/2017
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 083105 | — | OR |