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General NPI Number Information
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NPI Number | 1326427006
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Entity Type | Individual
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Provider Name | PATRICIA MAE JUNGMANN BSPHARM
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Gender | Female
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Dates
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Enumeration Date | 05/27/2015
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Last Update Date | 05/27/2015
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Provider Practice Location Address
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Address Line | 1575 NE 3RD ST
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City | PRINEVILLE
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State | OR
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Zip | 97754-2907
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Country | US
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Telephone | 541-447-2466
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Fax |
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Provider Business Mailing Address
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Address Line | 1293 NE ROSEMONT ST
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City | PRINEVILLE
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State | OR
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Zip | 97754-1370
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Country | US
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Telephone | 503-931-9551
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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 | 7240
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License Number State | OR
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