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NPI 1194725101

NPI 1194725101 : MARCUS W COX RPH : CHILOQUIN, OR

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General NPI Number Information
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    NPI Number           |    1194725101
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    Entity Type          |    Individual 
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    Provider Name        |    MARCUS W COX RPH
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/01/2005
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    Last Update Date     |    03/07/2023
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Provider Practice Location Address
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    Address Line         |    330 CHILOQUIN BLVD 
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    City                 |    CHILOQUIN
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    State                |    OR
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    Zip                  |    97624-6773
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    Country              |    US
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    Telephone            |    541-783-3551
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 490 
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    City                 |    CHILOQUIN
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    State                |    OR
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    Zip                  |    97624
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    Country              |    US
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    Telephone            |    541-783-3551
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    Fax                  |    541-783-3554
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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       |    RPH0009602
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    License Number State |    OR
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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       |    RPH0009602
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    License Number State |    OR
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