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General NPI Number Information
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NPI Number | 1699705947
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Entity Type | Organization
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Legal Business Name | SHERWILL, INC
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 01/05/2010
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Provider Practice Location Address
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Address Line | 212 N.E. MAIN ST
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City | WILLAMINA
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State | OR
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Zip | 97396-0037
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Country | US
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Telephone | 503-876-8652
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Fax | 503-876-2373
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Provider Business Mailing Address
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Address Line | PO BOX 37
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City | WILLAMINA
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State | OR
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Zip | 97396-0037
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Country | US
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Telephone | 503-876-8652
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Fax | 503-876-2373
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | KAMAL A KOTAICH
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Credential | RPH
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Telephone | 503-876-8652
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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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