Organization
SPECIALTY PHARMCY, INC
Active
Other names
Community Compounding Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN BRADEN PHARMD (PHARMACIST IN CHARGE)
(503) 303-7111
Entity
Organization
Contact information
Practice address
9150 SW PIONEER CT STE E, WILSONVILLE, OR 97070-9623
(503) 303-7111
(203) 210-0388
Mailing address
9150 SW PIONEER CT STE E, WILSONVILLE, OR 97070-9623
(503) 303-7111
(503) 210-0388
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
—
—
Other
Enumeration date
01/14/2014
Last updated
06/14/2022
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