Organization
WILLAMETTE COMPOUNDING PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN DWIGHT QUISENBERRY RPH (PRESIDENT)
(503) 364-3336
Entity
Organization
Contact information
Practice address
150 LIBERTY ST SE, SALEM, OR 97301-3506
(504) 364-3336
Mailing address
150 LIBERTY ST SE, SALEM, OR 97301-3506
(504) 364-3336
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
2122
OR
Other
Enumeration date
04/10/2008
Last updated
04/10/2008
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