# RXMEDLAB PHARMACY , LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** RxMedLab Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528306081
- **Authorized official:** MR. DENNIS RAY CLARK R.PH. (PHARMACIST / OWNER)
- **Authorized official phone:** (541) 474-3784

## Contact information

- **Practice address:** 162 NE BEACON DR, SUITE \# 109, GRANTS PASS, OR 97526-4260
- **Practice address phone:** (541) 474-3784
- **Mailing address:** 162 NE BEACON DR, SUITE \# 109, GRANTS PASS, OR 97526-4260
- **Mailing address phone:** (541) 474-3784

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0004X | Compounding Pharmacy | 2763 | OR | Yes |
| 3336S0011X | Specialty Pharmacy | 2763 | OR | — |

## Other

- **Enumeration date:** 01/17/2013
- **Last updated:** 01/17/2013