Healthcare Provider Details

I. General information

NPI: 1083182372
Provider Name (Legal Business Name): VIRGIL A GUTHRIE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2018
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

648 THOMPSON AVE NE
SALEM OR
97301-2753
US

IV. Provider business mailing address

648 THOMPSON AVE NE
SALEM OR
97301-2753
US

V. Phone/Fax

Practice location:
  • Phone: 503-576-1739
  • Fax:
Mailing address:
  • Phone: 503-576-1739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH-0016862
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: