NPI: 1114968815 · PORTLAND, OR 97202 · Community/Retail Pharmacy · NPI assigned 06/10/2006
| Authorized Official | HUBBELL, PATRICK (PIC/OWNER) |
| NPI Enumeration Date | 06/10/2006 |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 15 | $0.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 0011A | 15 | 12 | $0.00 |