Individual
MR. GLENN ALEXANDER FRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
808 SECOND AVE., GOLD HILL, OR 97525
(541) 855-1544
(541) 855-1040
Mailing address
PO BOX 259, GOLD HILL, OR 97525-0259
(541) 855-1544
(541) 855-1040
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5852
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5852
LICENSE NUMBER
OR
Enumeration date
08/07/2006
Last updated
07/08/2007
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