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General NPI Number Information
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NPI Number | 1245610005
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Entity Type | Organization
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Legal Business Name | BI-MART CORPORATION
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Dates
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Enumeration Date | 06/05/2015
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Last Update Date | 01/20/2020
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Provider Practice Location Address
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Address Line | 220 S SENECA RD
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City | EUGENE
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State | OR
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Zip | 97402-2725
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Country | US
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Telephone | 541-868-1766
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Fax |
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Provider Business Mailing Address
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Address Line | 220 S SENECA RD
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City | EUGENE
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State | OR
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Zip | 97402-2725
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VP OF PHARMACY
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Name | BRIAN CROOK
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Credential | RPH
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Telephone | 541-868-1761
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | RP0002710
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License Number State | OR
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