Individual
DELOY LAMAR DENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
113 E CENTRAL AVE, SUTHERLIN, OR 97479-9556
(541) 915-7323
Mailing address
113 E CENTRAL AVE, SUTHERLIN, OR 97479-9556
(541) 459-2712
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
007066
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007066
—
OR
Enumeration date
10/01/2019
Last updated
10/01/2019
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