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Organization
ASSURED PHARMACY
Active
Organization
ASSURED PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MUTTER (CHIEF OPS OFC)
(949) 222-9971
Entity
Organization
Contact information
Practice address
10196 SW PARK WAY, PORTLAND, OR 97225-5008
(503) 292-0045
(503) 292-0059
Mailing address
PO BOX 23, FRANKLIN PARK, NJ 08823-0023
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
RP0002215CS
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3841889
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
06/19/2006
Last updated
08/22/2020
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