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NPI Code Detail

MEDICARE: SUSAN LEA GOE RPH

MEDICARE: SUSAN LEA GOE RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist6518OR

General Provider Information

NPI Number : 1033111828
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN LEA GOE RPH
Provider Business Mailing Address
First Line : 3584 WYEAST RD
Second Line :
City : HOOD RIVER
State : OR
Zip : 97031-9429
Country : US
Telephone Number : 354-354-1772
Fax Number :
Provider Business Practice Location Address
First Line : 811 13TH ST
Second Line :
City : HOOD RIVER
State : OR
Zip : 97031-1204
Country : US
Telephone Number : 541-387-6338
Fax Number : 541-387-8213
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2005
Last Update Date : 07/08/2007

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Directions to “ SUSAN LEA GOE RPH” Practice Location

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