Provider Demographics
NPI:1104926211
Name:GARVEY, MARY L (MS PHARM)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:L
Last Name:GARVEY
Suffix:
Gender:F
Credentials:MS PHARM
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:913 NW GARDEN VALLEY BLVD
Mailing Address - Street 2:VA ROSEBURG HEALTH CARE SYSTEM PHARMACY DEPT.
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97470-6523
Mailing Address - Country:US
Mailing Address - Phone:541-440-1000
Mailing Address - Fax:541-440-1204
Practice Address - Street 1:913 NW GARDEN VALLEY BLVD
Practice Address - Street 2:VA ROSEBURG HEALTH CARE SYSTEM PHARMACY DEPT.
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97470-6523
Practice Address - Country:US
Practice Address - Phone:541-440-1000
Practice Address - Fax:541-440-1204
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA15142183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist