# MEDFORD PHARMACY GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** White City Community Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366379372
- **Authorized official:** JEFFREY SHANE HARRELL (OWNER)
- **Authorized official phone:** (360) 859-8659

## Contact information

- **Practice address:** 7591 CRATER LAKE HWY \# A, WHITE CITY, OR 97503-1663
- **Practice address phone:** (541) 826-4414
- **Practice address fax:** (541) 826-8366
- **Mailing address:** PO BOX B, ILWACO, WA 98624-0167

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 05/05/2026
- **Last updated:** 05/05/2026