MEDICARE: ALBERT LEE PHARMD

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
1	183500000X	Pharmacist	12458	OR

General Provider Information

NPI Number	:	1194025684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALBERT LEE PHARMD

Provider Business Mailing Address
First Line	:	19133 WILLAMETTE DR
Second Line	:
City	:	WEST LINN
State	:	OR
Zip	:	97068-2019
Country	:	US
Telephone Number	:	503-303-1099
Fax Number	:	503-303-1095

Provider Business Practice Location Address
First Line	:	19133 WILLAMETTE DR
Second Line	:
City	:	WEST LINN
State	:	OR
Zip	:	97068-2019
Country	:	US
Telephone Number	:	503-303-1099
Fax Number	:	503-303-1095

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2010
Last Update Date	:	07/20/2014

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