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Organization
RXMEDLAB PHARMACY , LLC
Active
Organization
RXMEDLAB PHARMACY , LLC
Active
Other names
RxMedLab Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENNIS RAY CLARK R.PH. (PHARMACIST / OWNER)
(541) 474-3784
Entity
Organization
Contact information
Practice address
162 NE BEACON DR, SUITE # 109, GRANTS PASS, OR 97526-4260
(541) 474-3784
Mailing address
162 NE BEACON DR, SUITE # 109, GRANTS PASS, OR 97526-4260
(541) 474-3784
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
2763
OR
3336S0011X
Specialty Pharmacy
2763
OR
Other
Enumeration date
01/17/2013
Last updated
01/17/2013
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