Wellformed AI

NPI 1215708243 · live from the CMS NPI Registry

1918 Winter Street Operating Co LLC

Pharmacy, Community/Retail Pharmacy in Grants Pass, OR. National Provider Identifier 1215708243, active.

NPI record

NPI1215708243 Type 2 · organization
StatusActive
Primary specialtyPharmacy, Community/Retail Pharmacy 3336C0003X
Practice location115 Se 7th St, Grants Pass, OR 97526
Practice phone541-956-7546
Mailing address7 Corporate Dr, Keene, NH 03431
EnumeratedJanuary 9, 2024
Last updatedJuly 24, 2024
Authorized officialKevin Mcnamara, Authorized Person
Other namesSafeway Pharmacy #0290

Taxonomies and licenses

TaxonomyCodeLicense
Durable Medical Equipment & Medical Supplies332B00000X—
Pharmacy, Community/Retail Pharmacy primary3336C0003X—

Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.