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CENTRAL DRUG STORE INC.
NPI 1124847074
Pharmacy - Long Term Care Pharmacy in Medford, OR

Active since October 08, 2024
2924 SISKIYOU BLVD STE 102, MEDFORD, OR 97504(541) 773-5356(541) 770-2999 Get Directions Write a Review

NPPES record last updated: December 20, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 20, 2025, Oct 8, 2024 (2 updates tracked since 2024).

About Central Drug Store Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CENTRAL DRUG STORE INC. (NPI 1124847074), doing business as Black Oak Pharmacy Ltc, is a healthcare organization registered as a long term care pharmacy in Medford, Oregon and active in the NPI registry since October 2024. The organization lists Jeffrey Shane Harrell, Owner, as its authorized official.

NPPES Registry Identity

NPI1124847074
Entity TypeOrganization
Primary Taxonomy3336L0003X
Legal Business NameCENTRAL DRUG STORE INC.
Location Address2924 SISKIYOU BLVD STE 102Medford, OR 97504-8194
Mailing AddressPo Box BIlwaco, WA 98624-0167
Phone(541) 773-5356
Fax(541) 770-2999
Organization SubpartNo
Authorized OfficialJeffrey Shane HarrellOwner · (360) 859-8659
Enumeration DateOctober 8, 2024
Last NPPES UpdateDecember 20, 20252 updates tracked since enumeration
NPPES CertifiedDecember 20, 2025
✔ NPI 1124847074 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Long Term Care PharmacySuppliers
Taxonomy Code3336L0003X
Definition
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.
2924 SISKIYOU BLVD STE 102, Medford, OR 97504
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Other Names 1

Doing Business AsBlack Oak Pharmacy Ltc

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TIMOTHY L LICHLYTER RPH
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
2924 SISKIYOU BLVD STE 102
MEDFORD, OR 97504
Jackson County (541) 773-5356

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Central Drug Store Inc.'s NPI number?

The NPI number for Central Drug Store Inc. is 1124847074. It was assigned to this organization in the NPPES registry on October 8, 2024. The provider is doing business as Black Oak Pharmacy LTC.

Where is Central Drug Store Inc. located?

Central Drug Store Inc. is located at 2924 Siskiyou Blvd Ste 102, Medford, OR 97504. The listed phone number is (541) 773-5356.

What is Central Drug Store Inc.'s specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Long Term Care Pharmacy, with taxonomy code 3336L0003X.

What insurance does Central Drug Store Inc. accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 35 other insurers list Central Drug Store Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Central Drug Store Inc. was last updated on December 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.