# QUISENBERRY HEALTH SYSTEM PHARMACY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Quisenberry Health System Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760859367
- **Authorized official:** STEVE QUISENBERRY (OWNER)
- **Authorized official phone:** (503) 364-3336

## Contact information

- **Practice address:** 148 LIBERTY ST SE, SALEM, OR 97301-3506
- **Practice address phone:** (503) 364-3336
- **Mailing address:** 150 LIBERTY ST SE, SALEM, OR 97301-3506
- **Mailing address phone:** (503) 364-3336

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | IP-0002261-CS | OR | Yes |

## Other

- **Enumeration date:** 08/31/2015
- **Last updated:** 08/31/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2153772 | PK | — |