Organization
QUISENBERRY HEALTH SYSTEM PHARMACY, LLC
Active
Other names
Quisenberry Health System Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE QUISENBERRY (OWNER)
(503) 364-3336
Entity
Organization
Contact information
Practice address
148 LIBERTY ST SE, SALEM, OR 97301-3506
(503) 364-3336
Mailing address
150 LIBERTY ST SE, SALEM, OR 97301-3506
(503) 364-3336
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
IP-0002261-CS
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2153772
PK
—
Enumeration date
08/31/2015
Last updated
08/31/2015
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