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Organization
CONFEDERATED TRIBES OF THE GRAND RONDE COMMUNITY OF OREGON
Active
Organization
CONFEDERATED TRIBES OF THE GRAND RONDE COMMUNITY OF OREGON
Active
Other names
Confederated Tribes of Grand Ronde Health & Wellness Center Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
LINCOLN WRIGHT PHARMD (PHARMACY DIRECTOR)
(503) 879-2299
Entity
Organization
Contact information
Practice address
9605 GRAND RONDE RD, GRAND RONDE, OR 97347-9712
(503) 879-2342
(503) 879-2030
Mailing address
9605 GRAND RONDE RD, GRAND RONDE, OR 97347-9712
(503) 879-2060
(503) 879-2071
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0002X
Clinic Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2079588
PK
—
Enumeration date
06/02/2008
Last updated
08/12/2024
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