Individual
MR. GERALD DAVID FAIRBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
2400 LANCASTER DR NE, SALEM, OR 97305-1221
(800) 972-7207
Mailing address
2400 LANCASTER DR NE, SALEM, OR 97305-1221
(800) 972-7207
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8874
OR
Other
Enumeration date
03/23/2010
Last updated
03/23/2010
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