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General NPI Number Information
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NPI Number | 1518472968
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Entity Type | Individual
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Provider Name | KURT ALAN BOESGER R.PH
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Gender | Male
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Dates
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Enumeration Date | 12/07/2017
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Last Update Date | 12/07/2017
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Provider Practice Location Address
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Address Line | 306 WEST NORTH STREET
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City | ENTERPRISE
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State | OR
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Zip | 97828
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Country | US
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Telephone | 541-426-7455
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Fax | 541-426-7445
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Provider Business Mailing Address
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Address Line | 306 WEST NORTH STREET
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City | ENTERPRISE
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State | OR
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Zip | 97828
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Country | US
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Telephone | 541-426-7455
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Fax | 541-426-7445
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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 | PHA-PHA-LIC-39893
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH-0013994
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS53244
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH015299
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License Number State | GA
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