Individual
CHANCHAL AGR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5807 MAIN ST, SPRINGFIELD, OR 97478-6961
(541) 726-8426
Mailing address
4300 GOODPASTURE LOOP APT 39, EUGENE, OR 97401-1415
(541) 908-2357
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0015909
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2586028
WALGREENS
—
Enumeration date
05/22/2017
Last updated
05/22/2017
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