Organization
RITE AID
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TENZIN BOTTOROFF RPH (RPH MGR)
(541) 756-7531
Entity
Organization
Contact information
Practice address
2040 BROADWAY ST, NORTH BEND, OR 97459-2328
(541) 756-7531
(541) 756-4136
Mailing address
2040 BROADWAY ST, NORTH BEND, OR 97459-2328
(541) 756-7531
(541) 756-4136
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
9818
OR
Other
Enumeration date
06/30/2010
Last updated
06/30/2010
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