Provider Demographics
NPI:1114232089
Name:CHEUVRONT, JUSTIN K (PHARMD, JD)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:K
Last Name:CHEUVRONT
Suffix:
Gender:M
Credentials:PHARMD, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5807 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97478-6961
Mailing Address - Country:US
Mailing Address - Phone:541-726-8423
Mailing Address - Fax:541-726-8473
Practice Address - Street 1:5807 MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97478-6961
Practice Address - Country:US
Practice Address - Phone:541-726-8423
Practice Address - Fax:541-726-8473
Is Sole Proprietor?:No
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0010768183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist