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General NPI Number Information
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NPI Number | 1699197459
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Entity Type | Organization
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Legal Business Name | SPECIALTY PHARMCY, INC
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Dates
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Enumeration Date | 01/14/2014
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Last Update Date | 06/14/2022
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Provider Practice Location Address
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Address Line | 9150 SW PIONEER CT STE E
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City | WILSONVILLE
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State | OR
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Zip | 97070-9623
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Country | US
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Telephone | 503-303-7111
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Fax | 203-210-0388
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Provider Business Mailing Address
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Address Line | 9150 SW PIONEER CT STE E
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City | WILSONVILLE
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State | OR
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Zip | 97070-9623
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Country | US
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Telephone | 503-303-7111
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Fax | 503-210-0388
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | LAUREN BRADEN
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Credential | PHARMD
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Telephone | 503-303-7111
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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