Provider Demographics
NPI:1205133667
Name:CHEUVRONT, TERESA HEILIG (RPH)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:HEILIG
Last Name:CHEUVRONT
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 1:1041 LAWRENCE ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3414
Mailing Address - Country:US
Mailing Address - Phone:541-345-9142
Mailing Address - Fax:
Practice Address - Street 1:1891 PIONEER PKWY E
Practice Address - Street 2:
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:2011-02-22
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR08149183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA29383OtherPHARMACIST LICENSE - CALIFORNIA