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Organization
BAKER CITY PHARMACY LLC
Active
Organization
BAKER CITY PHARMACY LLC
Active
Other names
Baker City Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY YENCOPAL (OWNER/MANAGER)
(541) 523-6745
Entity
Organization
Contact information
Practice address
1920 RESORT ST, BAKER CITY, OR 97814-2726
(541) 523-5231
Mailing address
1920 RESORT ST, BAKER CITY, OR 97814-2726
(541) 523-5231
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
RP0002658
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2131779
PK
—
Enumeration date
08/22/2011
Last updated
02/05/2014
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