Provider Demographics
NPI:1043228570
Name:SAMUELS, LINDA M (RPH)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:SAMUELS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38515 PIT RD
Mailing Address - Street 2:
Mailing Address - City:PHILOMATH
Mailing Address - State:OR
Mailing Address - Zip Code:97370-9771
Mailing Address - Country:US
Mailing Address - Phone:541-929-4222
Mailing Address - Fax:541-737-7616
Practice Address - Street 1:109 PLAGEMAN BLDG
Practice Address - Street 2:OSU PHARMACY
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97331
Practice Address - Country:US
Practice Address - Phone:541-737-3491
Practice Address - Fax:541-737-7616
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5812183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist