Provider Demographics
NPI:1891387288
Name:NEUFELD, MELVIN LEE
Entity Type:Individual
Prefix:
First Name:MELVIN
Middle Name:LEE
Last Name:NEUFELD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OR
Mailing Address - Zip Code:97355-4223
Mailing Address - Country:US
Mailing Address - Phone:541-259-1225
Mailing Address - Fax:541-259-1210
Practice Address - Street 1:185 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OR
Practice Address - Zip Code:97355-4223
Practice Address - Country:US
Practice Address - Phone:541-259-1225
Practice Address - Fax:541-259-1210
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-07
Last Update Date:2021-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR62641835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist