# DAHISSE INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Myrtle Drugs LTC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215782339
- **Authorized official:** JEFFREY SHANE HARRELL (OWNER)
- **Authorized official phone:** (360) 244-5984

## Contact information

- **Practice address:** 821 S MAIN ST, MYRTLE CREEK, OR 97457-9334
- **Practice address phone:** (541) 391-8321
- **Practice address fax:** (541) 391-8381
- **Mailing address:** PO BOX B, ILWACO, WA 98624-0167

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 04/22/2024
- **Last updated:** 04/22/2024