Organization
LEGACY MERIDAN PARK HOSPITAL
Active
Other names
Meridian Park Medical Center Community Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL SIEG RPH (PHCY SRVCS MGR)
(503) 692-2665
Entity
Organization
Contact information
Practice address
19300 SW 65TH AVE, TUALATIN, OR 97062-7706
(503) 692-7470
(503) 692-7437
Mailing address
19300 SW 65TH AVE, TUALATIN, OR 97062-7706
(503) 692-2454
(503) 692-7437
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
RP-0000864
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2144384
PK
—
Enumeration date
02/21/2014
Last updated
03/09/2015
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