Provider Demographics
NPI:1386826212
Name:AHLGREN, NORA MARIE (RPH)
Entity Type:Individual
Prefix:MS
First Name:NORA
Middle Name:MARIE
Last Name:AHLGREN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1891 PIONEER PKWY E
Mailing Address - Street 2:SAFEWAY 1094
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-3935
Mailing Address - Country:US
Mailing Address - Phone:541-747-6627
Mailing Address - Fax:541-726-6649
Practice Address - Street 1:1891 PIONEER PKWY E
Practice Address - Street 2:SAFEWAY 1094
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-3935
Practice Address - Country:US
Practice Address - Phone:541-747-6627
Practice Address - Fax:541-726-6649
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0006308183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist