OrganizationActive
Powell Pharmacy, LLC
NPI 1699104372 · Community/Retail Pharmacy · Portland, OR
Provider details
- NPI number
- 1699104372
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Gary Dontsov, Managing Member(818) 687-7368
- License
- RP0002838CS (OR)
Specialties & taxonomies
Suppliers
Practice location
11050 Se Powell Blvd Ste 375
Portland, OR 97266-1863
Phone: (818) 687-7368
Approximate (ZIP-level) locationGet directions
Mailing address
11050 Se Powell Blvd Ste 375
Portland, OR 97266-1863
Registry dates
- Enumerated
- 2013-11-04
- Last updated
- 2013-11-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.