Provider Demographics
NPI:1063789063
Name:OLIGER, REBECCA D (RPH)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:D
Last Name:OLIGER
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 1:366 COUNTY ROAD 1434
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653-3629
Mailing Address - Country:US
Mailing Address - Phone:870-425-7057
Mailing Address - Fax:
Practice Address - Street 1:350 HIGHWAY 62 E
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-3629
Practice Address - Country:US
Practice Address - Phone:870-424-3814
Practice Address - Fax:870-424-3845
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-19
Last Update Date:2011-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD08807183500000X
TN8833183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist