Healthcare Provider Details
I. General information
NPI: 1154418036
Provider Name (Legal Business Name): JO DELL'S DRUGS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
884 RIVER RD STE A
EUGENE OR
97404-3233
US
IV. Provider business mailing address
884 RIVER RD STE A
EUGENE OR
97404-3233
US
V. Phone/Fax
- Phone: 541-688-0390
- Fax: 541-688-1287
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | IP0001952CS |
| License Number State | OR |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336I0012X |
| Taxonomy | Institutional Pharmacy |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 227833 |
| Identifier Type | MEDICAID |
| Identifier State | OR |
| Identifier Issuer | |
| # 2 | |
| Identifier | 3842122 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | OTHER ID NUMBER-COMMERCIAL NUMBER |
VIII. Authorized Official
Name:
JODELL
OFFORD
Title or Position: PRESIDENT
Credential:
Phone: 541-688-0390