Austin Landreville, PHARMD
Individual provider Active NPI Pharmacist · Stayton, OR
NPI 1124610209 · NPPES record last updated Feb 9, 2021
Key facts
- NPI
- 1124610209
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH-0018018 (OR)
- Practice address
- 1401 N 10TH Ave
Stayton, OR 97383-1311 - Phone
- (503) 769-9223
- Fax
- (503) 769-2479
- NPI assigned
- Feb 9, 2021
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH-0018018 | OR | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH-0018018 | OR | Yes |
Addresses
Primary practice location
1401 N 10TH Ave
Stayton, OR 97383-1311
Mailing address
1401 N 10TH Ave
Stayton, OR 97383-1311
Phone (503) 769-9223
Other providers in Stayton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 9, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.