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General NPI Number Information
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NPI Number | 1215168711
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Entity Type | Organization
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Legal Business Name | PROVIDENCE MILWAUKIE HOSPITAL
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Dates
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Enumeration Date | 07/31/2009
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Last Update Date | 07/31/2009
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Provider Practice Location Address
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Address Line | 10150 SE 32ND AVE
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City | MILWAUKIE
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State | OR
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Zip | 97222-6516
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Country | US
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Telephone | 503-513-8338
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Fax |
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Provider Business Mailing Address
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Address Line | 10150 SE 32ND AVE
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City | MILWAUKIE
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State | OR
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Zip | 97222-6516
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Country | US
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Telephone | 503-513-8338
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | DR. EVON CHINYERE ANUKAM
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Credential | PHARMD
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Telephone | 503-513-8338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | RPH-0010023
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | RPH-0010023
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License Number State | OR
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