Healthcare Provider Details

I. General information

NPI: 1477223816
Provider Name (Legal Business Name): JAMES EDWARD CALHOUN RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2021
Last Update Date: 09/16/2021
Certification Date: 09/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 MAIN ST
SWEET HOME OR
97386-3339
US

IV. Provider business mailing address

621 MAIN ST
SWEET HOME OR
97386-3339
US

V. Phone/Fax

Practice location:
  • Phone: 541-367-6777
  • Fax: 541-367-6500
Mailing address:
  • Phone: 541-367-6777
  • Fax: 541-367-6500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH-0008196
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: