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Organization
PRESBYTERIAN NURSING HOME
Active
Organization
PRESBYTERIAN NURSING HOME
Active
Other names
PHS Long Term Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CATHLEEN SULLIVAN PHARM.D. (EXEC DIR ADMIN)
(541) 889-9133
Entity
Organization
Contact information
Practice address
1085 N OREGON ST, ONTARIO, OR 97914-1549
(541) 889-6157
(541) 889-6148
Mailing address
1085 N OREGON ST, ONTARIO, OR 97914-1549
(541) 889-6157
(541) 889-6148
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
00736
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
073874
—
OR
01
—
2078441
PK
—
Enumeration date
08/14/2006
Last updated
12/18/2016
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