Provider Demographics
NPI:1164552758
Name:MURRAY, ANN MARIE (RPH)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:MARIE
Last Name:MURRAY
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:PO BOX 427
Mailing Address - Street 2:
Mailing Address - City:HEPPNER
Mailing Address - State:OR
Mailing Address - Zip Code:97836-0427
Mailing Address - Country:US
Mailing Address - Phone:541-676-9631
Mailing Address - Fax:
Practice Address - Street 1:217 N. MAIN STR
Practice Address - Street 2:
Practice Address - City:HEPPNER
Practice Address - State:OR
Practice Address - Zip Code:97836-0427
Practice Address - Country:US
Practice Address - Phone:541-676-9158
Practice Address - Fax:541-676-5015
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR7667183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR7667OtherOREGON STATE LISCENSE NUM