Healthcare Provider Details

I. General information

NPI: 1720122427
Provider Name (Legal Business Name): TALENT HEALTH RX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 09/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 TALENT AVE 223
TALENT OR
97540
US

IV. Provider business mailing address

PO BOX 223
TALENT OR
97540-0223
US

V. Phone/Fax

Practice location:
  • Phone: 541-535-8881
  • Fax: 541-512-1535
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2369
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier3842677
Identifier TypeOTHER
Identifier State
Identifier IssuerOTHER ID NUMBER
# 2
Identifier3842677
Identifier TypeOTHER
Identifier State
Identifier IssuerOTHER ID NUMBER-COMMERCIAL NUMBER

VIII. Authorized Official

Name: ANGIE MEEKER
Title or Position: OWNER AND PIC
Credential:
Phone: 541-535-8881