# MALHEUR DRUG, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Malheur Drug
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326158585
- **Authorized official:** DR. JENNIFER L. TOLMAN PHARM.D. (PHARMACIST)
- **Authorized official phone:** (541) 473-3333

## Contact information

- **Practice address:** 198 A ST W, VALE, OR 97918-1302
- **Practice address phone:** (541) 473-3333
- **Practice address fax:** (541) 473-9689
- **Mailing address:** 198 A ST W, VALE, OR 97918-1302
- **Mailing address phone:** (541) 473-3333
- **Mailing address fax:** (541) 473-9689

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | RP-0000577-CS | OR | Yes |
| 3336I0012X | Institutional Pharmacy | IP-0001182-CS | OR | — |
| 3336L0003X | Long Term Care Pharmacy | IP-0001182-CS | OR | — |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 01/22/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 130203 | — | OR |
| 01 | — | 3805263 | NCPDP | — |