Umpqua Community Health Center, INC.
Pharmacy, Community/Retail Pharmacy in Roseburg, OR. Organization (NPI-2).
NPI number1023747813
StatusActive
Last updated in NPPESJun 9, 2022
Details
- NPI
- 1023747813
- Entity type
- Organization (NPI-2)
- Legal business name
- Umpqua Community Health Center, INC.
- Organization subpart
- No
- Enumeration date
- Jun 7, 2022
- Certification date
- Jun 9, 2022
- Last updated
- Jun 9, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | – | Yes |
Other names
- Aviva Health Pharmacy (Doing Business As)
Practice location
150 Ne Kenneth Ford DrRoseburg, OR 97470-1042
Phone 541-672-9596 · Fax 541-492-2060
Mailing address
150 Ne Kenneth Ford DrRoseburg, OR 97470-1042
Phone 541-672-9596 · Fax 541-492-2060
Authorized official
Kc Bolton
Chief Executive Officer
5416729596
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