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General NPI Number Information
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NPI Number | 1861773798
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Entity Type | Organization
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Legal Business Name | GRANTS PASS PHARMACY, INC.
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Dates
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Enumeration Date | 09/06/2011
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 414 SW 6TH ST.
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City | GRANTS PASS
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State | OR
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Zip | 97526-2810
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Country | US
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Telephone | 541-476-4262
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Fax | 541-474-1443
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Provider Business Mailing Address
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Address Line | 414 SW 6TH ST.
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City | GRANTS PASS
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State | OR
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Zip | 97526-2810
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Country | US
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Telephone | 541-476-4262
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Fax | 541-474-1443
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Authorized Official
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Title or Position | VP OF OPERATIONS
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Name | MS. MICHELE M BELCHER
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Credential | RPH
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Telephone | 541-476-4262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 0001164
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number | 0001164
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License Number State | OR
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