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Organization
REDMOND LONG TERM CARE PHARMACY LLC
Active
Organization
REDMOND LONG TERM CARE PHARMACY LLC
Active
Other names
Redmond Long Term Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE EDMONDSON (OWNER/RPH)
(541) 526-1771
Entity
Organization
Contact information
Practice address
424 NW 5TH ST STE A, REDMOND, OR 97756-1627
(541) 526-1771
(541) 504-5476
Mailing address
424 NW 5TH STREET, SUITE A, REDMOND, OR 97756
(541) 526-1771
(541) 504-5476
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
IP0002253CS
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146400
PK
—
Enumeration date
07/02/2014
Last updated
07/02/2014
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