# PRESBYTERIAN NURSING HOME

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PHS Long Term Care Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528071206
- **Authorized official:** CATHLEEN SULLIVAN PHARM.D. (EXEC DIR ADMIN)
- **Authorized official phone:** (541) 889-9133

## Contact information

- **Practice address:** 1085 N OREGON ST, ONTARIO, OR 97914-1549
- **Practice address phone:** (541) 889-6157
- **Practice address fax:** (541) 889-6148
- **Mailing address:** 1085 N OREGON ST, ONTARIO, OR 97914-1549
- **Mailing address phone:** (541) 889-6157
- **Mailing address fax:** (541) 889-6148

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | 00736 | OR | Yes |

## Other

- **Enumeration date:** 08/14/2006
- **Last updated:** 12/18/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 073874 | — | OR |
| 01 | — | 2078441 | PK | — |