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General NPI Number Information
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NPI Number | 1033455688
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Entity Type | Individual
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Provider Name | KELLY DROLLINGER PHARMD
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Gender | Male
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Dates
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Enumeration Date | 12/28/2012
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 88 SW 3RD AVE
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City | ONTARIO
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State | OR
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Zip | 97914-2722
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Country | US
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Telephone | 503-986-6952
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Fax | 541-889-0027
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Provider Business Mailing Address
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Address Line | 507 CORNWALL WAY
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City | FRUITLAND
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State | ID
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Zip | 83619-2548
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Country | US
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Telephone | 208-860-5863
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | P6004
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | RPH-0011243
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License Number State | OR
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