Organization
ASANTE
Active
Other names
Rogue Valley Medical Center Outpatient Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARVIN D HAAS (CAFO)
(541) 789-4103
Entity
Organization
Contact information
Practice address
2825 E BARNETT RD, MEDFORD, OR 97504-8332
(541) 789-7000
Mailing address
2825 E BARNETT RD, MEDFORD, OR 97504-8332
(541) 789-7000
Taxonomy
Speciality
Code
Description
License number
State
3336H0001X
Home Infusion Therapy Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120451
—
OR
01
—
4963900004
MEDICARE DMERCK
OR
Enumeration date
11/13/2007
Last updated
12/05/2007
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