Provider Demographics
NPI:1033482385
Name:STRATEGIC PHARMACEUTICAL SOLUTIONS INC
Entity type:Organization
Organization Name:STRATEGIC PHARMACEUTICAL SOLUTIONS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MGR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:HYSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-802-7400
Mailing Address - Street 1:17014 NE SANDY BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230
Mailing Address - Country:US
Mailing Address - Phone:503-802-7400
Mailing Address - Fax:877-684-3301
Practice Address - Street 1:17014 NE SANDY BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-5074
Practice Address - Country:US
Practice Address - Phone:503-802-7400
Practice Address - Fax:877-684-3301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-17
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
ORRP-0002429-CS3336M0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2133850OtherPK