Provider Demographics
NPI:1245085174
Name:STRATEGIC PHARMACEUTICAL SOLUTIONS, INC. MINORITY SHAREHOLDERS
Entity type:Organization
Organization Name:STRATEGIC PHARMACEUTICAL SOLUTIONS, INC. MINORITY SHAREHOLDERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGULATORY ASSOCIATE
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:HYSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-802-7400
Mailing Address - Street 1:17014 NE SANDY BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230-5074
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4251 DALE EARNHARDT BLVD.
Practice Address - Street 2:STE 100
Practice Address - City:NORTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76262
Practice Address - Country:US
Practice Address - Phone:877-738-4443
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy