Organization
PROVIDENCE HEALTH & SERVICES OREGON
Active
Other names
PROVIDENCE MILWAUKIE HOSP PHCY
Organization subpart
No
Provider details
NPI number
Authorized official
SUZANNE ANTHONY RPH (PHARMACIST IN CHARGE)
(503) 513-8381
Entity
Organization
Contact information
Practice address
10150 SE 32ND AVE, MILWAUKIE, OR 97222-6516
(503) 513-8331
(503) 513-8324
Mailing address
10150 SE 32ND AVE, MILWAUKIE, OR 97222-6516
(503) 513-8331
(503) 513-8324
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
RP0000827CS
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
175620
—
OR
01
—
3802837
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/27/2006
Last updated
03/04/2013
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