National Provider Identifier Database

SISKIYOU COMMUNITY HEALTH CENTER PHARMACY
Clinic Pharmacy

A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.


Contact Information

SISKIYOU COMMUNITY HEALTH CENTER PHARMACY
25647 REDWOOD HWY
CAVE JUNCTION, OR97523-9332
Phone: 541-592-4111
Fax: 541-592-3916
Website:
Specialty Taxonomy Code
* Clinic Pharmacy 3336C0002X

* Indicates primary specialty

NPI Profile & details for SISKIYOU COMMUNITY HEALTH CENTER PHARMACY

NPI Number 1396141255
Legal business name
LBN
SISKIYOU COMMUNITY HEALTH CENTER PHARMACY
Authorized official RICHARD BOOTH - (CEO)
Entity Organization
Organization subpart No
Enumeration date 11/05/2014
Last updated 10/06/2021 - About 5 years ago
Sole proprietor1 Not specified
Identifiers
  • OR License #: RP-0003008-CS
  • OR Medicaid: 500679920

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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