Organization
ASSURED PHARMACY NORTHWEST INC.
Active
Other names
Assured Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRANK TYLER ROBLES (CONTRACTING ADMINISTRATOR)
(949) 222-9971
Entity
Organization
Contact information
Practice address
3822 SE POWELL BLVD, PORTLAND, OR 97202-1720
(503) 238-4540
(503) 238-0323
Mailing address
17935 SKY PARK CIR STE F, IRVINE, CA 92614-4336
(949) 222-9971
(949) 271-5580
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
RP-0002791 CS
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3815365
NCPDP
OR
Enumeration date
12/19/2006
Last updated
08/22/2020
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