Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Central Drug Store Inc

Organization Pharmacy · NPI 1790830446

Central Drug Store Inc is a Pharmacy in Shady Cove, Oregon. Licensed in Oregon. Registered with an NPI since 2007.

Licensed in
OR
In the registry since
2007
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

21195 Hwy 62
Shady Cove, OR 97539-9715
Phone: (541) 878-3151
Fax: (541) 878-8228
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X · Licence RP0000715CS (OR)
Pharmacy Taxonomy 333600000X

Record details

NPI number1790830446
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Timothy Lichlyter — President · (541) 494-2616
Other names Shady Cove Pharmacy
NPI enumeratedJanuary 24, 2007
Last updated in NPPESAugust 25, 2010
Mailing addressPo Box 700, Shady Cove, OR 97539-0700