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General NPI Number Information
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NPI Number | 1053353821
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Entity Type | Organization
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Legal Business Name | EPPIK INC
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 05/31/2012
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Provider Practice Location Address
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Address Line | 201 VILLA RD
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City | NEWBERG
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State | OR
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Zip | 97132-1828
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Country | US
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Telephone | 503-538-5715
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Fax | 503-537-1068
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Provider Business Mailing Address
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Address Line | 201 VILLA RD
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City | NEWBERG
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State | OR
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Zip | 97132-1828
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Country | US
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Telephone | 503-538-5715
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Fax | 503-537-1068
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | MICHAEL DOUGLAS
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Credential |
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Telephone | 503-538-5715
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 00327
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License Number State | OR
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