Provider Demographics
NPI:1427201102
Name:WELGEMOED, LLOYD DION (RPH)
Entity Type:Individual
Prefix:MR
First Name:LLOYD
Middle Name:DION
Last Name:WELGEMOED
Suffix:
Gender:M
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 935
Mailing Address - Street 2:
Mailing Address - City:NEOTSU
Mailing Address - State:OR
Mailing Address - Zip Code:97364-0935
Mailing Address - Country:US
Mailing Address - Phone:541-921-1642
Mailing Address - Fax:541-994-4713
Practice Address - Street 1:4101 NW LOGAN RD
Practice Address - Street 2:
Practice Address - City:LINCOLN CITY
Practice Address - State:OR
Practice Address - Zip Code:97367-5056
Practice Address - Country:US
Practice Address - Phone:541-994-2500
Practice Address - Fax:866-994-8438
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0011154183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR0011154OtherLICENSE