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General NPI Number Information
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NPI Number | 1811908668
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Entity Type | Organization
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Legal Business Name | PEACE HEALTH PHARMACY
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1200 HILYARD ST STE S-110
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City | EUGENE
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State | OR
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Zip | 97439-8112
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Country | US
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Telephone | 541-349-7630
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Fax | 541-349-7630
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Provider Business Mailing Address
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Address Line | 1200 HILYARD ST STE S-110
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City | EUGENE
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State | OR
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Zip | 97439-8112
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Country | US
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Telephone | 541-349-7630
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Fax | 541-349-7632
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Authorized Official
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Title or Position | PHARMICIST IN CHARGE
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Name | DAVID LEGER-JEFFREY
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Credential | RPH
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Telephone | 541-349-7630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | 001133
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License Number State | OR
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