WELLNESS COMPOUNDING PHARMACY
522 Crater Lake Ave
Medford, OR 97504
541-774-3939
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 333600000X | Suppliers - Pharmacy - | ||
N | 3336C0003X | Suppliers - Pharmacy | ||
Y | 3336C0004X | Suppliers - Pharmacy | OR | RP002452C0S |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
500738873 | OR | MEDICAID | |
PK | 2079579 | OTHER |