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Organization
WILSON DRUG INC
Active
Organization
WILSON DRUG INC
Active
Other names
TILLAMOOK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID WILSON (OWNER)
(503) 842-4181
Entity
Organization
Contact information
Practice address
915 MAIN AVE, TILLAMOOK, OR 97141-3815
(503) 842-4181
(503) 842-1147
Mailing address
915 MAIN AVE, TILLAMOOK, OR 97141-3815
(503) 842-4181
(503) 842-1147
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
RP-0000561
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182365
—
OR
01
—
2077217
PK
—
Enumeration date
01/30/2007
Last updated
09/28/2016
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