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General NPI Number Information
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NPI Number | 1609919760
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Entity Type | Organization
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Legal Business Name | DANCA LENNA INC
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 09/12/2007
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Provider Practice Location Address
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Address Line | 1023 MAIN ST
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City | SWEET HOME
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State | OR
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Zip | 97386-1515
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Country | US
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Telephone | 541-367-4231
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Fax | 541-367-2825
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Provider Business Mailing Address
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Address Line | 1023 MAIN ST
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City | SWEET HOME
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State | OR
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Zip | 97386-1515
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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 | OWNER
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Name | DAVID REDDEN
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Credential | RPH
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Telephone | 541-367-4668
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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 | 00506
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License Number State | OR
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