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General NPI Number Information
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NPI Number | 1700609906
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Entity Type | Organization
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Legal Business Name | ROGUE COMMUNITY HEALTH
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Dates
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Enumeration Date | 11/05/2024
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 19 MYRTLE ST
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City | MEDFORD
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State | OR
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Zip | 97504-7337
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Country | US
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Telephone | 541-842-7747
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Fax | 541-842-7637
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Provider Business Mailing Address
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Address Line | 19 MYRTLE ST
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City | MEDFORD
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State | OR
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Zip | 97504-7337
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Country | US
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Telephone | 541-842-7747
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Fax | 541-842-7637
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Authorized Official
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Title or Position | SENIOR DIRECTOR OF PHARMACY
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Name | AMY CERVAN
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Credential |
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Telephone | 541-200-6859
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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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