Organization
ACHTERHOF HEALTHCARE PHARMACY, LLC
Active
Other names
Managed Healthcare Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL SCOTT KLEMM RPH (OPERATIONS MANAGER)
(541) 744-1641
Entity
Organization
Contact information
Practice address
1750 WILLOW CREEK CIR, EUGENE, OR 97402-9152
(541) 744-1641
Mailing address
PO BOX 2767, EUGENE, OR 97402-0308
(541) 744-1641
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
001218
OR
333600000X
Pharmacy
Primary
001218
OR
3336L0003X
Long Term Care Pharmacy
IP-0001218-CS
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181400
—
OR
05
—
181401
—
OR
Enumeration date
09/09/2005
Last updated
01/27/2016
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