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General NPI Number Information
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NPI Number | 1548684491
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Entity Type | Individual
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Provider Name | DOUGLAS WAYNE RUTHERFORD I PHARMACIST
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Gender | Male
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Dates
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Enumeration Date | 02/13/2014
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Last Update Date | 12/02/2020
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Provider Practice Location Address
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Address Line | 230 N CEDAR ST
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City | BORGER
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State | TX
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Zip | 79007-4026
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Country | US
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Telephone | 806-273-1433
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Fax | 806-273-2053
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Provider Business Mailing Address
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Address Line | 230 N CEDAR ST
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City | BORGER
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State | TX
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Zip | 79007-4026
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Country | US
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Telephone | 806-273-1433
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Fax | 806-273-3244
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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 | 32896
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License Number State | TX
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