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Organization

COMMUNITY PHARMACY REDMOND

Active
Other names
Community Pharmacy Redmond
Organization subpart
No

Provider details

NPI number
Authorized official
JIM DIEGEL (CEO)
(541) 382-4321
Entity
Organization

Contact information

Practice address
1253 NW CANAL BLVD, REDMOND, OR 97756-1334
(541) 516-3807
(541) 516-3815
Mailing address
1253 NW CANAL BLVD, REDMOND, OR 97756-1334
(541) 516-3807
(541) 516-3815

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
RP002979CS
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2148646
PK
05
282848
OR
Enumeration date
11/13/2014
Last updated
11/13/2014
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