Organization
PHOENIX DOWNTOWN PHARMACY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN EGENDOERFER (PHARMACIST)
(541) 301-1473
Entity
Organization
Contact information
Practice address
404 N MAIN ST, PHOENIX, OR 97535-9632
(541) 301-1473
Mailing address
116 MEADOW VIEW DR, PHOENIX, OR 97535-9431
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
RP 0000299 CS
OR
Other
Enumeration date
03/27/2013
Last updated
03/27/2013
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