Organization
ASSURED PHARMACY GRESHAM INC
Active
Other names
ASSURED PHARMACY GRESHAM
Organization subpart
No
Provider details
NPI number
Authorized official
JULIETTE JOHNSON (ACCOUNTING ANALYST)
(972) 668-7394
Entity
Organization
Contact information
Practice address
831 NW COUNSIL DR, STE 115, GRESHAM, OR 97030
(971) 223-0552
(503) 492-2148
Mailing address
5760 LEGACY DR, STE. B3-518, PLANO, TX 75024-7102
(972) 668-7394
(866) 232-1680
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
RP0002366
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3842590
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/31/2006
Last updated
03/07/2013
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