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NPI Code Detail

MEDICARE: MS. CORYNA MICHELLE HUDGINS RPH

MEDICARE:  MS. CORYNA MICHELLE HUDGINS  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
1183500000XPharmacist8592OR

General Provider Information

NPI Number : 1558489963
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CORYNA MICHELLE HUDGINS RPH
Provider Business Mailing Address
First Line : 5364 WILLOW LEAF ST N
Second Line :
City : KEIZER
State : OR
Zip : 97303-7528
Country : US
Telephone Number : 503-390-8749
Fax Number :
Provider Business Practice Location Address
First Line : 5452 RIVER RD N
Second Line : RITEAID PHARMACY
City : KEIZER
State : OR
Zip : 97303-4429
Country : US
Telephone Number : 503-393-8950
Fax Number : 503-390-7838
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2007
Last Update Date : 07/08/2007

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Directions to “ MS. CORYNA MICHELLE HUDGINS RPH” Practice Location

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