Individual
MR. RICK A. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
833 E CENTRAL AVE, PO BOX X, SUTHERLIN, OR 97479-9607
(541) 459-0626
(866) 269-5778
Mailing address
833 E CENTRAL AVE, PO BOX X, SUTHERLIN, OR 97479-9607
(541) 459-0626
(866) 269-5778
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8342
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8342
STATE PHARMACIST LICENSE
OR
Enumeration date
02/10/2012
Last updated
10/09/2012
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