Organization
GORDON'S PHARMACY AND GIFTS LLC
Active
Other names
Gordon's Pharmacy and Gifts
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID ALLEN STEVENS R.PH. (PRESIDENT)
(541) 839-4452
Entity
Organization
Contact information
Practice address
314 SOUTH MAIN STREET, CANYONVILLE, OR 97417-0746
(541) 839-4452
(541) 839-4254
Mailing address
PO BOX 746, CANYONVILLE, OR 97417-0746
(541) 839-4452
(541) 839-4254
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
RP0000162CS
OR
3336C0003X
Community/Retail Pharmacy
Primary
RP0000162CS
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
229336
—
OR
05
—
274197
—
OR
01
—
3805655
NCPDP NUMBER
—
Enumeration date
01/30/2007
Last updated
12/02/2010
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