Provider Demographics
NPI:1205901485
Name:POSTAL PHARMACY INC
Entity type:Organization
Organization Name:POSTAL PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAHAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:541-782-2617
Mailing Address - Street 1:PO BOX 697
Mailing Address - Street 2:
Mailing Address - City:OAKRIDGE
Mailing Address - State:OR
Mailing Address - Zip Code:97463
Mailing Address - Country:US
Mailing Address - Phone:541-782-2617
Mailing Address - Fax:541-782-3413
Practice Address - Street 1:47809 HWY 58
Practice Address - Street 2:
Practice Address - City:OAKRIDGE
Practice Address - State:OR
Practice Address - Zip Code:97463
Practice Address - Country:US
Practice Address - Phone:541-782-2617
Practice Address - Fax:541-782-3413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0000338333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3800047OtherNABP-NCPDP
OR138859Medicaid
3800047OtherNABP-NCPDP