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Organization
GOOD SHEPHERD MEDICAL SERVICE CORP
Active
Organization
GOOD SHEPHERD MEDICAL SERVICE CORP
Active
Other names
GOOD SHEPHERD BOARDMAN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ADAMS (DIRECTOR OF PHARMACY)
(541) 667-3746
Entity
Organization
Contact information
Practice address
220 S. MAIN, BOARDMAN, OR 97818
(541) 667-3746
(541) 667-3749
Mailing address
220 S. MAIN, BOARDMAN, OR 97818
(541) 667-3746
(541) 667-3749
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
RP-0002702
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2134514
PK
—
Enumeration date
04/13/2012
Last updated
09/30/2015
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