# ALBANY GENERAL HOSPITAL

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

## Provider details

- **NPI number:** 1548313356
- **Authorized official:** DAVID TRIEBES MBA (CEO)
- **Authorized official phone:** (541) 812-4102

## Contact information

- **Practice address:** 1010 7TH AVE SW, ALBANY, OR 97321-1922
- **Practice address phone:** (541) 812-5071
- **Mailing address:** 1010 7TH AVE SW, ALBANY, OR 97321-1922
- **Mailing address phone:** (541) 812-5071

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 00104 | OR | Yes |

## Other

- **Enumeration date:** 01/18/2007
- **Last updated:** 11/21/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | RP-0000104-CS | STATE LICENSE | OR |