Provider Demographics
NPI:1952950339
Name:EGAN, JANICE CZECH (PHARMD)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:CZECH
Last Name:EGAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:MARGARET
Other - Last Name:CZECH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:106 NW F ST PMB 495
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-2012
Mailing Address - Country:US
Mailing Address - Phone:702-325-0400
Mailing Address - Fax:541-472-7212
Practice Address - Street 1:500 SW RAMSEY AVE
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97527-5554
Practice Address - Country:US
Practice Address - Phone:541-472-7212
Practice Address - Fax:541-472-7213
Is Sole Proprietor?:No
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR161151835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy