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Organization

UMPQUA COMMUNITY HEALTH CENTER, INC.

Active
Other names
Aviva Health Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
KC BOLTON (CHIEF EXECUTIVE OFFICER)
(541) 672-9596
Entity
Organization

Contact information

Practice address
150 NE KENNETH FORD DR, ROSEBURG, OR 97470-1042
(541) 672-9596
(541) 492-2060
Mailing address
150 NE KENNETH FORD DR, ROSEBURG, OR 97470-1042
(541) 672-9596
(541) 492-2060

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary

Other

Enumeration date
06/07/2022
Last updated
06/09/2022
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