Organization
WILSON DRUG INC
Active
Other names
tillamook pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID G WILSON (OWNER)
(503) 842-4181
Entity
Organization
Contact information
Practice address
915 MAIN AVE, TILLAMOOK, OR 97141-3815
(503) 842-4181
(503) 842-1147
Mailing address
915 MAIN AVE, TILLAMOOK, OR 97141-3815
(503) 842-4181
(503) 842-1147
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
561
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
293016
—
OR
Enumeration date
07/05/2007
Last updated
02/04/2008
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