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Individual

LEROY ERNEST ROBERTS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
R.PH.

Contact information

Practice address
38850 CAMP CREEK ROAD, SPRINGFIELD, OR 97478
(541) 726-7993
Mailing address
38850 CAMP CREEK ROAD, SPRINGFIELD, OR 97478
(541) 726-7993

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0005028
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RPH-0005028
PHARMACIST LICENSE #
OR
Enumeration date
03/16/2007
Last updated
07/08/2007
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