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Organization
ASSURED PHARMACY GRESHAM INC
Active
Organization
ASSURED PHARMACY GRESHAM INC
Active
Other names
ASSURED PHARMACY GRESHAM
Organization subpart
No
Provider details
NPI number
Authorized official
JULIETTE JOHNSON (ACCOUNTING ANALYST)
(972) 668-7394
Entity
Organization
Contact information
Practice address
831 NW COUNSIL DR, STE 115, GRESHAM, OR 97030
(971) 223-0552
(503) 492-2148
Mailing address
5760 LEGACY DR, STE. B3-518, PLANO, TX 75024-7102
(972) 668-7394
(866) 232-1680
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
RP0002366
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3842590
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/31/2006
Last updated
03/07/2013
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