Provider Demographics
NPI:1700857737
Name:O'CALLAGHAN, TERR2 JOHN (RPH)
Entity Type:Individual
Prefix:MR
First Name:TERR2
Middle Name:JOHN
Last Name:O'CALLAGHAN
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 1:2160 NE KIM LN
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-6055
Mailing Address - Country:US
Mailing Address - Phone:541-382-4697
Mailing Address - Fax:
Practice Address - Street 1:325 NE FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4917
Practice Address - Country:US
Practice Address - Phone:541-382-1454
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0005645183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist