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General NPI Number Information
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NPI Number | 1144729013
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Entity Type | Individual
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Provider Name | STEPHEN HOTRUM PHARMD
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Gender | Male
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Dates
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Enumeration Date | 02/06/2018
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 444 PACIFIC AVE S
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City | MONMOUTH
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State | OR
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Zip | 97361-1543
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Country | US
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Telephone | 503-838-1176
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Fax | 866-267-6597
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Provider Business Mailing Address
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Address Line | 2734 7TH AVE SE APT 3
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City | ALBANY
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State | OR
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Zip | 97322-5006
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Country | US
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Telephone | 208-220-6291
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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 | P7392
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 14106
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License Number State | OR
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