Individual
DR. COLIN FAHEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2700 NW STEWART PKWY, ROSEBURG, OR 97471-1281
(541) 673-0611
Mailing address
1437 NW GROVE ST, ROSEBURG, OR 97471-6147
(458) 210-5704
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0016440
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RPH-0016440
OREGON BOARD OF PHARMACY
OR
Enumeration date
06/08/2018
Last updated
06/08/2018
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