Provider Demographics
NPI:1497405831
Name:CARIS PHARMACY, INC
Entity Type:Organization
Organization Name:CARIS PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CROOK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:541-736-6169
Mailing Address - Street 1:PO BOX 40221
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97404-0028
Mailing Address - Country:US
Mailing Address - Phone:541-736-6169
Mailing Address - Fax:
Practice Address - Street 1:25013 HIGHWAY 126
Practice Address - Street 2:
Practice Address - City:VENETA
Practice Address - State:OR
Practice Address - Zip Code:97487-9492
Practice Address - Country:US
Practice Address - Phone:541-833-5700
Practice Address - Fax:503-833-5701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy