Provider Demographics
NPI:1598725319
Name:RHSO CORP
Entity Type:Organization
Organization Name:RHSO CORP
Other - Org Name:KING ROAD HI-SCHOOL PHARMCAY #1175
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:HARTMANN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:503-659-1840
Mailing Address - Street 1:4200 SE KING RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-5259
Mailing Address - Country:US
Mailing Address - Phone:503-659-1840
Mailing Address - Fax:503-652-1049
Practice Address - Street 1:4200 SE KING RD
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-5259
Practice Address - Country:US
Practice Address - Phone:503-659-1840
Practice Address - Fax:503-652-1049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRP0000290CS332B00000X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR029855Medicaid
3810555OtherNCPDP