Provider Demographics
NPI:1891755799
Name:STROHECKERS PHARMACY INC
Entity Type:Organization
Organization Name:STROHECKERS PHARMACY INC
Other - Org Name:STROHECKERS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:DULWICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-720-9485
Mailing Address - Street 1:1286 SE HOLGATE BLVD
Mailing Address - Street 2:SUITE C-1
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-5053
Mailing Address - Country:US
Mailing Address - Phone:503-222-4822
Mailing Address - Fax:503-222-4868
Practice Address - Street 1:1286 SE HOLGATE BLVD
Practice Address - Street 2:SUITE C-1
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-5053
Practice Address - Country:US
Practice Address - Phone:503-222-4822
Practice Address - Fax:503-222-4868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-24
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X, 3336C0004X
ORRP-0000985-CS3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2077938OtherPK