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NPI Code Detail

MEDICARE: GUY HAVICE RPH

MEDICARE: GUY HAVICE 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
1183500000XPharmacistRPH-0010662OR
21835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistRPH-0010662OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RPH-0010662OTHERORSTATE PHARMACIST LICENSE

General Provider Information

NPI Number : 1598038382
Entity Type Code : Individual
Provider Name (Legal Business Name) : GUY HAVICE RPH
Provider Business Mailing Address
First Line : 8385 DIVISION RD
Second Line :
City : WHITE CITY
State : OR
Zip : 97503-1176
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8385 DIVISION RD
Second Line :
City : WHITE CITY
State : OR
Zip : 97503-1176
Country : US
Telephone Number : 541-500-0989
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2012
Last Update Date : 06/21/2023

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