Organization
YANTIS ENTERPRISES INC
Active
Other names
Corner Drug
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY YANTIS (OWNER)
(541) 247-4544
Entity
Organization
Contact information
Practice address
29670 ELLENSBURG AVE, GOLD BEACH, OR 97444-8701
(541) 247-4544
(541) 247-2604
Mailing address
29670 ELLENSBURG AVE, GOLD BEACH, OR 97444-8701
(541) 247-4544
(541) 247-2604
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
RP0000218
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2123262
PK
—
05
—
500615354
—
OR
Enumeration date
06/08/2006
Last updated
03/30/2016
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