Organization
CENTRAL DRUG STORE INC.
Active
Organization
CENTRAL DRUG STORE INC.
Active
Other names
Black Oak Home Medical
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY HARRELL PHARMD (OWNER)
(360) 859-8659
Entity
Organization
Contact information
Practice address
4800 CRATER LAKE AVE, MEDFORD, OR 97504-9753
(541) 773-5083
Mailing address
PO BOX B, ILWACO, WA 98624-0167
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
RP0000767
OR
Other
Enumeration date
10/21/2008
Last updated
12/29/2025
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