Organization
HIGHLAND PARK PHARMACY LLC
Active
Other names
REDMOND PHARMACY AND COMPOUNDING CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE EDMONDSON RPH (OWNER)
(541) 526-1771
Entity
Organization
Contact information
Practice address
424 NW 5TH ST, REDMOND, OR 97756
(541) 526-1771
(541) 504-5476
Mailing address
424 NW 5TH STREET, REDMOND, OR 97756
(541) 526-1771
(541) 504-5476
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
RP0002394
OR
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2079550
PK
—
05
—
278755
—
OR
Enumeration date
05/09/2007
Last updated
10/31/2014
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