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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