Organization
GOOD SHEPHERD MEDICAL SERVICE CORP
Active
Other names
GOOD SHEPHERD BOARDMAN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ADAMS (DIRECTOR OF PHARMACY)
(541) 667-3746
Entity
Organization
Contact information
Practice address
220 S. MAIN, BOARDMAN, OR 97818
(541) 667-3746
(541) 667-3749
Mailing address
220 S. MAIN, BOARDMAN, OR 97818
(541) 667-3746
(541) 667-3749
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
RP-0002702
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2134514
PK
—
Enumeration date
04/13/2012
Last updated
09/30/2015
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