# HILLSBORO PHARMACY & FOUNTAIN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Hillsboro Pharmacy & Fountain
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972615987
- **Authorized official:** JASMINE NGUYEN (OWNER)
- **Authorized official phone:** (360) 450-9194

## Contact information

- **Practice address:** 155 SE 2ND AVE, HILLSBORO, OR 97123-4026
- **Practice address phone:** (503) 648-1811
- **Practice address fax:** (503) 640-1514
- **Mailing address:** 155 SE 2ND AVE, HILLSBORO, OR 97123-4026
- **Mailing address phone:** (503) 648-1811
- **Mailing address fax:** (503) 640-1514

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | RP-0000237-CS | OR | Yes |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 03/23/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 083758 | — | OR |
| 01 | — | 2077319 | PK | — |