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Organization
ACHTERHOF HEALTHCARE PHARMACY, LLC
Active
Organization
ACHTERHOF HEALTHCARE PHARMACY, LLC
Active
Other names
Managed Healthcare Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL SCOTT KLEMM RPH (OPERATIONS MANAGER)
(541) 744-1641
Entity
Organization
Contact information
Practice address
1750 WILLOW CREEK CIR, EUGENE, OR 97402-9152
(541) 744-1641
Mailing address
PO BOX 2767, EUGENE, OR 97402-0308
(541) 744-1641
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
001218
OR
333600000X
Pharmacy
Primary
001218
OR
3336L0003X
Long Term Care Pharmacy
IP-0001218-CS
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181400
—
OR
05
—
181401
—
OR
Enumeration date
09/09/2005
Last updated
01/27/2016
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