Gresham Professional Pharmacy

NPI #1063401198 in Gresham, Oregon

Provider Information

NPI Number
1063401198
Entity Type
Organization
Organization Name
Gresham Professional Pharmacy
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Oct 20, 2005
Last Updated
Oct 21, 2008

Practice Location

Address
24076 SE STARK ST
Address 2
SUITE 100
State
Oregon
ZIP Code
97030-3373
Phone
(503) 491-0117

Authorized Official

Name
DR. DAVID G MOLL, PHARMD
Title
CEO
Phone
(503) 491-0117

Specialties & Taxonomy Codes

Specialty
Pharmacist
Pharmacy - Community/Retail PharmacyCommunity/Retail Pharmacy

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