Organization
CAMPUS DRUG, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SONJA C BRYANT RPH (OWNER)
(541) 883-1147
Entity
Organization
Contact information
Practice address
2218 SHALLOCK AVE, KLAMATH FALLS, OR 97601-4290
(541) 883-1147
(541) 882-7308
Mailing address
2218 SHALLOCK AVE, KLAMATH FALLS, OR 97601-4290
(541) 883-1147
(541) 882-7308
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
RP-0000892-CS
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
280974
—
OR
Enumeration date
08/19/2006
Last updated
07/15/2008
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