Provider Demographics
NPI:1336121300
Name:RHODEN, DEANNA MARIE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:MARIE
Last Name:RHODEN
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 1:4800 COLEMAN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-9657
Mailing Address - Country:US
Mailing Address - Phone:541-789-5850
Mailing Address - Fax:541-789-5851
Practice Address - Street 1:4800 COLEMAN CREEK RD
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-9657
Practice Address - Country:US
Practice Address - Phone:541-789-5850
Practice Address - Fax:541-789-5851
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0009683183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist