NPI 1780738138 · live from the CMS NPI Registry
Central Drug Store INC
Pharmacy, Community/Retail Pharmacy in Medford, OR. National Provider Identifier 1780738138, active.
NPI record
| NPI | 1780738138 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Pharmacy, Community/Retail Pharmacy 3336C0003X |
| Practice location | 2924 Siskiyou Blvd, Ste 102, Medford, OR 97504 |
| Practice phone | 541-773-5356 |
| Mailing address | Po Box B, Ilwaco, WA 98624 |
| Enumerated | January 23, 2007 |
| Last updated | December 22, 2025 |
| Authorized official | Jeffrey Harrell, Owner |
| Other names | Black Oak Pharmacy |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | — |
| Pharmacy | 333600000X | — |
| Pharmacy, Community/Retail Pharmacy primary | 3336C0003X | RP-0000767 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.