NPI 1003289877

Stephen Wilson, RPH

Practitioner Pharmacist Bandon, OR

Practice location

Address: 44 Michigan Ave NE, Bandon, OR 97411-9743
Phone: (541) 347-9457
Mailing address: PO Box 69, Bandon, OR 97411-0069

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 6360 (OR)

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Registry record

NPI: 1003289877
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 Nov 2015
Record last updated: 3 Nov 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.