Organization
RXDIRECT, INC.
Active
Parent organization
RX DIRECT, INC
Other names
Jennings McCall Center Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
RX DIRECT, INC
Authorized official
PHUONG M PHAN CPHT (ADMINISTRATOR)
(503) 657-9422
Entity
Organization
Contact information
Practice address
2300 MASONIC WAY, FOREST GROVE, OR 97116-2043
(503) 357-4499
(503) 357-4479
Mailing address
16246 SE MCLOUGHLIN BLVD, MILWAUKIE, OR 97267
(503) 657-9422
(503) 656-0278
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
RP-0001701-CS
OR
3336L0003X
Long Term Care Pharmacy
Primary
IP-0001981-CS
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210400
—
OR
Enumeration date
07/26/2006
Last updated
02/01/2008
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