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Organization
BANDON PHARMACY
Active
Organization
BANDON PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID SWENSON (OWNER)
(503) 347-2222
Entity
Organization
Contact information
Practice address
1225 OREGON AVE, BANDON, OR 97411-0369
(541) 347-2222
(541) 347-4241
Mailing address
PO BOX 369, BANDON, OR 97411-0369
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
RP0000132
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163063
—
OR
01
—
3807041
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
02/06/2007
Last updated
07/10/2008
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