Organization
STAYTON PHARMACY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMIE NETLAND R.PH (OWNER)
(503) 769-2616
Entity
Organization
Contact information
Practice address
102 MARTIN DR, SUITE A, STAYTON, OR 97383-1296
(503) 769-2616
(503) 769-9449
Mailing address
102 MARTIN DR, SUITE A, STAYTON, OR 97383-1296
(503) 769-2616
(503) 769-9449
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
3805011
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210311
—
OR
05
—
297159
—
OR
Enumeration date
07/21/2006
Last updated
04/02/2015
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