Provider Demographics
NPI:1588131296
Name:HOME TOWN DRUGS OF COTTAGE GROVE, INC.
Entity type:Organization
Organization Name:HOME TOWN DRUGS OF COTTAGE GROVE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:DEBYSINGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-942-7799
Mailing Address - Street 1:P.O. BOX #940
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97424
Mailing Address - Country:US
Mailing Address - Phone:541-930-7799
Mailing Address - Fax:
Practice Address - Street 1:1205 HWY 99 NORTH
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:OR
Practice Address - Zip Code:97424
Practice Address - Country:US
Practice Address - Phone:541-930-7799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-31
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy