Organization
J & I BLACK, INC.
Active
Other names
Sutherlin Drug
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IAN L BLACK B.S., R.PH. (PRESIDENT)
(541) 459-2712
Entity
Organization
Contact information
Practice address
113 E CENTRAL AVE, SUTHERLIN, OR 97479-9556
(541) 459-2712
(541) 459-9129
Mailing address
PO BOX 309, SUTHERLIN, OR 97479-0309
(541) 459-2712
(541) 459-9129
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-7673
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126404
—
OR
01
—
3811557
NCPDP #
OR
Enumeration date
06/16/2006
Last updated
08/22/2020
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