Organization
SAFEWAY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEAN CLARK (RPH)
(541) 660-7657
Entity
Organization
Contact information
Practice address
2001 TABLE ROCK RD, APT 28, MEDFORD, OR 97501-1483
(541) 660-7657
Mailing address
2001 TABLE ROCK RD, APT 28, MEDFORD, OR 97501-1483
(541) 660-7657
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
0015445
OR
Other
Enumeration date
08/29/2016
Last updated
08/29/2016
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