Healthcare Provider Details

I. General information

NPI: 1336158385
Provider Name (Legal Business Name): FRUM HEALTH CARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 SECOND AVE.
GOLD HILL OR
97525
US

IV. Provider business mailing address

PO BOX 259
GOLD HILL OR
97525-0259
US

V. Phone/Fax

Practice location:
  • Phone: 541-885-1544
  • Fax: 541-855-1040
Mailing address:
  • Phone: 541-855-1544
  • Fax: 541-855-1040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number00917
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number00917
License Number StateOR

VIII. Authorized Official

Name: MR. GLENN ALEXANDER FRUM
Title or Position: OWNER/PRESIDENT
Credential: R.PH.
Phone: 541-855-1544