Organization
EPPIK INC
Active
Other names
MIKES MEDICAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL DOUGLAS (PHARMACIST/OWNER)
(503) 538-5715
Entity
Organization
Contact information
Practice address
201 VILLA RD, NEWBERG, OR 97132-1828
(503) 538-5715
(503) 537-1068
Mailing address
201 VILLA RD, NEWBERG, OR 97132-1828
(503) 538-5715
(503) 537-1068
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
00327
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117861
—
OR
01
—
3802990
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/13/2006
Last updated
05/31/2012
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