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Organization
CENTRAL DRUG STORE INC
Active
Organization
CENTRAL DRUG STORE INC
Active
Other names
BLACK OAK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY HARRELL (OWNER)
(360) 859-8659
Entity
Organization
Contact information
Practice address
2924 SISKIYOU BLVD, STE 102, MEDFORD, OR 97504-8194
(541) 773-5356
(541) 770-2999
Mailing address
PO BOX B, ILWACO, WA 98624-0167
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
RP-0000767
OR
Other
Enumeration date
01/23/2007
Last updated
12/22/2025
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