Healthcare Provider Details

I. General information

NPI: 1003051558
Provider Name (Legal Business Name): HOWARD'S PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2008
Last Update Date: 10/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 N F ST
LAKEVIEW OR
97630-1529
US

IV. Provider business mailing address

101 N F ST
LAKEVIEW OR
97630-1529
US

V. Phone/Fax

Practice location:
  • Phone: 541-947-2141
  • Fax:
Mailing address:
  • Phone: 541-947-2141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number00266
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number00266
License Number StateOR

VIII. Authorized Official

Name: MR. J. JEFFREY HOWARD
Title or Position: PHARMACIST/OWNER/MANAGER
Credential:
Phone: 541-947-2141