Organization
HOME TOWN DRUGS OF ROSEBURG INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY SHANE HARRELL PHARMD (OWNER)
(360) 859-8659
Entity
Organization
Contact information
Practice address
1813 W HARVARD AVE STE 210, ROSEBURG, OR 97471-2709
(541) 229-1112
(541) 464-4530
Mailing address
1813 W HARVARD AVE STE 210, ROSEBURG, OR 97471-2709
(541) 229-1112
(541) 464-4530
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274394
—
OR
01
—
3842831
NCPDP
OR
Enumeration date
10/30/2017
Last updated
12/20/2025
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