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NPI Code Detail

MEDICARE: DR. NATHAN ROUSE PHARM D

MEDICARE: DR. NATHAN ROUSE PHARM D
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
1183500000XPharmacist15089OR
21835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist0015089OR

General Provider Information

NPI Number : 1275913857
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NATHAN ROUSE PHARM D
Provider Business Mailing Address
First Line : 1340 NW WALL ST
Second Line :
City : BEND
State : OR
Zip : 97703-1985
Country : US
Telephone Number : 541-385-1071
Fax Number :
Provider Business Practice Location Address
First Line : 1340 NW WALL ST
Second Line :
City : BEND
State : OR
Zip : 97703-1985
Country : US
Telephone Number : 541-385-1071
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2015
Last Update Date : 07/21/2022

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Directions to “ DR. NATHAN ROUSE PHARM D” Practice Location

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