Service Drug Store

LBN: Outdoor World Inc
Service Drug Store is an health care organization with primary practice located at 1204 Nw 6Th St , Grants Pass OR 97526-1254. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Outdoor World Inc can be contacted via phone (541) 476-8224, or through Cantiello, Debbie via phone (541) 476-8224.

Contact Information

Primary practice address
1204 Nw 6Th St Grants Pass OR 97526-1254
Phone: (541) 476-8224
Fax: (541) 476-4132
Website:
Map and Directions
Authorized official contact:
Name: Cantiello, Debbie BS
Phone: (541) 476-8224

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X RP-0000217 Oregon

Profile Details

NPI number 1851473656
LBN Legal business name Outdoor World Inc
DBA Doing business as Service Drug Store
Authorized official Cantiello, Debbie BS
Entity Organization
Organization subpart 1 No
Enumeration date Oct 20th, 2006
Last updated Aug 26th, 2013 - about 13 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 1851473656 NPPES
Oregon MEDICAID 190751
Oregon Other 2077236

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