Provider Demographics
NPI:1578650776
Name:JO DELLS DRUGS INC
Entity Type:Organization
Organization Name:JO DELLS DRUGS INC
Other - Org Name:JO DELLS DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JODELL
Authorized Official - Middle Name:
Authorized Official - Last Name:OFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-688-0390
Mailing Address - Street 1:884 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97404-3233
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:884 RIVER RD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97404-3233
Practice Address - Country:US
Practice Address - Phone:541-688-0390
Practice Address - Fax:541-688-1287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-07
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
ORRP00001853336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR005111Medicaid
3801633OtherOTHER ID NUMBER
3801633OtherOTHER ID NUMBER-COMMERCIAL NUMBER
3801633OtherOTHER ID NUMBER-COMMERCIAL NUMBER