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General NPI Number Information
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NPI Number | 1942020326
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Entity Type | Organization
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Legal Business Name | SOUTHERN COOS HEALTH DISTRICT
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Dates
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Enumeration Date | 10/11/2024
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 900 11TH ST SE
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City | BANDON
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State | OR
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Zip | 97411-9114
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Country | US
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Telephone | 541-347-1325
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Fax |
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Provider Business Mailing Address
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Address Line | 900 11TH ST SE
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City | BANDON
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State | OR
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Zip | 97411-9114
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Country | US
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Telephone | 541-347-1325
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Fax | 541-347-6297
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Authorized Official
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Title or Position | CFO - AUTHORIZED OFFICIAL
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Name | MR. ANTONE J EEK
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Credential |
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Telephone | 503-544-6592
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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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