Organization
SHERWILL, INC
Active
Other names
WILLAMINA DRUGS
Organization subpart
No
Provider details
NPI number
Authorized official
KAMAL A KOTAICH RPH (OWNER)
(503) 876-8652
Entity
Organization
Contact information
Practice address
212 N.E. MAIN ST, WILLAMINA, OR 97396
(503) 876-8652
(503) 876-2373
Mailing address
PO BOX 37, WILLAMINA, OR 97396-0037
(503) 876-8652
(503) 876-2373
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
RP-0000580-CS
OR
333600000X
Pharmacy
RP-0000580-CS
OR
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
169708
—
OR
Enumeration date
11/17/2006
Last updated
01/19/2010
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