Organization
ASHLAND DRUG INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER FIDEL HERNANDEZ (OWNER)
(541) 482-3366
Entity
Organization
Contact information
Practice address
53 N. SECOND ST., ASHLAND, OR 97520
(541) 482-3366
(541) 482-2736
Mailing address
53 N. SECOND ST., ASHLAND, OR 97520
(541) 482-3366
(541) 482-2736
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
00111
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0380084-02
REGENCE HMO OREGON
OR
05
—
170160
—
OR
01
—
816033000
REGENCE BLUE CROSS BLUE S
OR
Enumeration date
10/13/2005
Last updated
04/14/2021
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