Organization
J MAC DRUG INC
Active
Other names
MCCANNS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA CUDAHY RPH (PHARM MGR)
(503) 639-7377
Entity
Organization
Contact information
Practice address
15685 SW 116TH AVE, KING CITY, OR 97224-2651
(503) 639-1171
(503) 620-2167
Mailing address
15685 SW 116TH AVE, KING CITY, OR 97224-2651
(503) 639-1171
(503) 620-2167
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0000563CS
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123596
—
OR
01
—
2077240
PK
—
Enumeration date
10/07/2006
Last updated
02/21/2017
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