Provider Demographics
NPI:1588433031
Name:TRACK TOWN PHARMACY INC
Entity type:Organization
Organization Name:TRACK TOWN PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BYOUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:JUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-915-0894
Mailing Address - Street 1:1373 OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3910
Mailing Address - Country:US
Mailing Address - Phone:541-844-7270
Mailing Address - Fax:541-844-7271
Practice Address - Street 1:1373 OLIVE ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3910
Practice Address - Country:US
Practice Address - Phone:541-915-0894
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-26
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy