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General NPI Number Information
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NPI Number | 1457108847
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Entity Type | Individual
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Provider Name | CHRISTOPHER ELEAZAR BRAIN-HERNANDEZ PHARMD
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Gender | Male
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Dates
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Enumeration Date | 05/02/2024
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Last Update Date | 05/02/2024
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Provider Practice Location Address
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Address Line | 3521 NW SAMARITAN DR LOWR LEVEL
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City | CORVALLIS
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State | OR
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Zip | 97330-4744
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Country | US
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Telephone | 541-768-5286
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Fax | 541-768-6662
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Provider Business Mailing Address
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Address Line | 2324 20TH AVE SE
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City | ALBANY
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State | OR
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Zip | 97322-5433
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Country | US
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Telephone | 805-758-7543
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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 | RPH-0019628
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License Number State | OR
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