SOUTH SALEM APOTHECARY, LLC
990 Commercial St Se
Salem, OR 97302
503-967-2407
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 333600000X | Suppliers - Pharmacy - | OR | RP0002199CS |
Y | 3336C0003X | Suppliers - Pharmacy |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
OTHER ID NUMBER | 3841865 | OTHER | |
231440 | OR | MEDICAID |