<Unavail>

LBN: Maple Street Clinic Pharmacy Llc
<Unavail> is an health care organization with primary practice located at 1825 Maple St , Forest Grove OR 97116-1939. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Clinic Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Clinic Pharmacy is the primary health care specialty. Maple Street Clinic Pharmacy Llc can be contacted via phone (503) 357-7552, or through Vorrath, Christopher via phone (503) 357-7552.

Contact Information

Primary practice address
1825 Maple St Forest Grove OR 97116-1939
Phone: (503) 357-7552
Fax: (503) 359-5071
Website:
Map and Directions
Authorized official contact:
Name: Vorrath, Christopher PHRM
Phone: (503) 357-7552

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Clinic Pharmacy 3336C0002X RP0000674CS Oregon
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1912064478
LBN Legal business name Maple Street Clinic Pharmacy Llc
DBA Doing business as <Unavail>
Authorized official Vorrath, Christopher PHRM
Entity Organization
Organization subpart 1 No
Enumeration date Jan 3rd, 2007
Last updated Jun 23rd, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912064478 NPPES
Oregon MEDICAID 0003280
Oregon Other 3810163
Oregon Other 3810163

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