<Unavail>

LBN: Professional 205 Pharmacy
<Unavail> is an health care organization with primary practice located at 10000 Se Main St Ste 118 , Portland OR 97216-2462. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Professional 205 Pharmacy can be contacted via phone (503) 255-2546, or through Hodge, Susan via phone (503) 255-2546.

Contact Information

Primary practice address
10000 Se Main St Ste 118 Portland OR 97216-2462
Phone: (503) 255-2546
Fax: (503) 255-3893
Website:
Map and Directions
Authorized official contact:
Name: Hodge, Susan
Phone: (503) 255-2546

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X RP,0000689 Oregon

Profile Details

NPI number 1639521149
LBN Legal business name Professional 205 Pharmacy
DBA Doing business as <Unavail>
Authorized official Hodge, Susan
Entity Organization
Organization subpart 1 No
Enumeration date Jul 8th, 2016
Last updated Aug 17th, 2016 - about 10 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 1639521149 NPPES
Other 2160623 PK

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