MEDICARE: ED TREHARNE JR. RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	RP-0000087-CS	OR

General Provider Information

NPI Number	:	1427801406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ED TREHARNE JR. RPH

Provider Business Mailing Address
First Line	:	1319 COMMERCIAL ST
Second Line	:
City	:	ASTORIA
State	:	OR
Zip	:	97103-3995
Country	:	US
Telephone Number	:	503-325-4541
Fax Number	:	503-325-6827

Provider Business Practice Location Address
First Line	:	1319 COMMERCIAL ST
Second Line	:
City	:	ASTORIA
State	:	OR
Zip	:	97103-3995
Country	:	US
Telephone Number	:	503-325-4541
Fax Number	:	503-325-6827

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2024
Last Update Date	:	04/09/2024

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Directions to “ ED TREHARNE JR. RPH” Practice Location

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