# R L GOFF ENTERPRISES, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Forest Grove Pharmacy LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700819323
- **Authorized official:** MR. RODNEY LOUIS GOFF RPH (PRESIDENT)
- **Authorized official phone:** (503) 357-7171

## Contact information

- **Practice address:** 2305 PACIFIC AVE, FOREST GROVE, OR 97116-2449
- **Practice address phone:** (503) 357-7171
- **Practice address fax:** (503) 357-7696
- **Mailing address:** 2305 PACIFIC AVE, FOREST GROVE, OR 97116-2449
- **Mailing address phone:** (503) 357-7171
- **Mailing address fax:** (503) 357-7696

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | RP0000209CS | OR | Yes |

## Other

- **Enumeration date:** 07/08/2006
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 025239 | — | OR |
| 01 | — | 3800035 | NCPDP | — |
| 01 | — | RP0000209CS | STATE BOARD LICENSE | OR |