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Contact Information

WALLOWA PHARMACY
207 EAST 1ST ST.
WALLOWA, OR97885
 Phone: 541-886-2361
 Fax: 541-886-6801
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for WALLOWA PHARMACY

NPI # 1730242421
LBN Legal business name WALLOWA PHARMACY
Authorized official JEAN FOSTER - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/18/2006
Last updated 03/19/2008 - About 18 years ago
Identifiers
OR License # RP0000584CS
OR Medicaid 179317
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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