J & I Black, Inc.
Organization Active NPI Pharmacist · Sutherlin, OR
NPI 1790729077 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1790729077
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH-7673 (OR)
- Legal business name
- J & I BLACK, INC.
- Practice address
- 113 E Central Ave
Sutherlin, OR 97479-9556 - Phone
- (541) 459-2712
- Fax
- (541) 459-9129
- NPI assigned
- Jun 16, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Ian L Black, B.S., R.PH.
- Title
- President
- Phone
- (541) 459-2712
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist |
183500000X | RPH-7673 | OR | Yes |
Addresses
Primary practice location
113 E Central Ave
Sutherlin, OR 97479-9556
Mailing address
PO Box 309
Sutherlin, OR 97479-0309
Phone (541) 459-2712
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 126404 | Medicaid | OR | |
| 3811557 | Other | OR | NCPDP # |
Other names
- Sutherlin Drug
Other providers in Sutherlin, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.