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General NPI Number Information
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NPI Number | 1376915207
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Entity Type | Organization
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Legal Business Name | STANDIFORD INVESTMENTS, LLC
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Dates
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Enumeration Date | 10/30/2015
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Last Update Date | 10/30/2015
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Provider Practice Location Address
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Address Line | 1409 HIGHWAY 101 S
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City | REEDSPORT
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State | OR
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Zip | 97467-1605
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Country | US
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Telephone | 541-271-3631
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Fax | 541-271-4855
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Provider Business Mailing Address
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Address Line | 1409 HIGHWAY 101 S
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City | REEDSPORT
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State | OR
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Zip | 97467-1605
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Country | US
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Telephone | 541-271-3631
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Fax | 541-271-4855
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Authorized Official
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Title or Position | PHARMACIST/MANAGER
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Name | DR. JAMAICA ROBERTA STANDIFORD
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Credential | PHARM. D.
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Telephone | 541-271-3631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | OR
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