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General NPI Number Information
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NPI Number | 1316839202
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Entity Type | Organization
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Legal Business Name | ST. CHARLES HEALTH SYSTEM, INC.
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Dates
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Enumeration Date | 07/16/2025
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 198 NE COMBS FLAT RD STE 100
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City | PRINEVILLE
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State | OR
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Zip | 97754-2563
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Country | US
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Telephone | 541-706-2972
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Fax | 541-797-5319
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Provider Business Mailing Address
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Address Line | 62968 LAYTON AVE STE 4
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City | BEND
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State | OR
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Zip | 97701-8763
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Country | US
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Telephone | 541-706-2972
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Fax | 541-797-5319
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Authorized Official
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Title or Position | DIRECTOR OF AMBULATORY PHARMACY
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Name | KEVIN E RUSSELL
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Credential |
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Telephone | 541-609-0306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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