Provider Demographics
NPI:1740603646
Name:SILVERTON HOSPITAL PHARMACY
Entity Type:Organization
Organization Name:SILVERTON HOSPITAL PHARMACY
Other - Org Name:SILVERTON HOSPITAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MYRNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-873-1573
Mailing Address - Street 1:342 FAIRVIEW ST
Mailing Address - Street 2:
Mailing Address - City:SILVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97381-1917
Mailing Address - Country:US
Mailing Address - Phone:503-873-1570
Mailing Address - Fax:503-873-1609
Practice Address - Street 1:342 FAIRVIEW ST
Practice Address - Street 2:
Practice Address - City:SILVERTON
Practice Address - State:OR
Practice Address - Zip Code:97381-1917
Practice Address - Country:US
Practice Address - Phone:503-873-1570
Practice Address - Fax:503-873-1609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-28
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORIP00007733336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2078303OtherPK