1918 Winter Street Operating Co LLC

NPI #1255102257 in Gresham, Oregon

Provider Information

NPI Number
1255102257
Entity Type
Organization
Organization Name
1918 Winter Street Operating Co LLC
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Jan 10, 2024
Last Updated
Jul 24, 2024

Practice Location

Address
1455 NE DIVISION ST
State
Oregon
ZIP Code
97030-4270
Phone
(503) 492-7279

Authorized Official

Name
KEVIN MCNAMARA
Title
AUTHORIZED PERSON
Phone
(603) 354-4619

Specialties & Taxonomy Codes

Specialty
Durable Medical Equipment & Medical Supplies
Pharmacy - Community/Retail PharmacyCommunity/Retail Pharmacy

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