# MEDFORD PHARMACY GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** West Main Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780781625
- **Authorized official:** JEFFREY S HARRELL PHARM D (OWNER)
- **Authorized official phone:** (360) 244-5984

## Contact information

- **Practice address:** 2355 W MAIN ST, MEDFORD, OR 97501
- **Practice address phone:** (541) 772-2330
- **Practice address fax:** (541) 772-4852
- **Mailing address:** PO BOX B, ILWACO, WA 98624
- **Mailing address phone:** (360) 642-3133
- **Mailing address fax:** (360) 642-5133

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | RP0000291CS | OR | Yes |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 08/26/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2146390 | PK | — |