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NPI Code Detail

MEDICARE: LINDA LOUISE OMURA RPH

MEDICARE:   LINDA LOUISE OMURA  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
1183500000XPharmacist10649CO

General Provider Information

NPI Number : 1588907794
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA LOUISE OMURA RPH
Provider Business Mailing Address
First Line : 135 S PLUM ST
Second Line :
City : FRUITA
State : CO
Zip : 81521-2524
Country : US
Telephone Number : 970-858-9508
Fax Number : 970-858-4685
Provider Business Practice Location Address
First Line : 135 S PLUM ST
Second Line :
City : FRUITA
State : CO
Zip : 81521-2524
Country : US
Telephone Number : 970-858-9508
Fax Number : 970-858-4685
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2013
Last Update Date : 04/05/2013

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Directions to “ LINDA LOUISE OMURA RPH” Practice Location

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