Organization
MODOC FAMILY PHARMACY INC
Active
Organization
MODOC FAMILY PHARMACY INC
Active
Other names
Shasta Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY SHANE HARRELL (OWNER)
(360) 859-8659
Entity
Organization
Contact information
Practice address
9340 DESCHUTES RD, PALO CEDRO, CA 96073-9763
(530) 233-3113
(530) 233-3140
Mailing address
PO BOX B, ILWACO, WA 98624-0167
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
06/26/2026
Last updated
06/26/2026
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