Organization
SHERIDAN PHARMACY, INC
Active
Other names
Sheridan Pharmacy 1155
Organization subpart
No
Provider details
NPI number
Authorized official
JACK L HOLT RPH (OWNER)
(360) 693-5879
Entity
Organization
Contact information
Practice address
103 E MAIN ST, SHERIDAN, OR 97378-1828
(503) 843-2422
(503) 843-5043
Mailing address
916 W EVERGREEN BLVD, VANCOUVER, WA 98660-3035
(360) 213-2236
(360) 213-2238
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
RP-0000500-CS
OR
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500625416
—
OR
Enumeration date
11/17/2006
Last updated
10/05/2010
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up