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General NPI Number Information
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NPI Number | 1245645274
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Entity Type | Individual
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Provider Name | LOREN EUGENE WRIGHT RPH
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Gender | Male
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Dates
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Enumeration Date | 06/28/2014
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Last Update Date | 06/28/2014
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Provider Practice Location Address
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Address Line | 5401 S WHITE MOUNTAIN RD
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City | SHOW LOW
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State | AZ
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Zip | 85901-7849
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Country | US
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Telephone | 928-368-3281
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Fax |
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Provider Business Mailing Address
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Address Line | 440 N 34TH DR
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City | SHOW LOW
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State | AZ
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Zip | 85901-4440
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Country | US
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Telephone | 928-368-3281
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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 | S10770
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License Number State | AZ
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