Provider Demographics
NPI:1548535487
Name:VIRNIG, GLORIA N (RPH)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:N
Last Name:VIRNIG
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 1:3450 COMMERCIAL ST SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-4635
Mailing Address - Country:US
Mailing Address - Phone:503-585-7660
Mailing Address - Fax:503-585-3541
Practice Address - Street 1:3450 COMMERCIAL ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4635
Practice Address - Country:US
Practice Address - Phone:503-585-7660
Practice Address - Fax:503-585-3541
Is Sole Proprietor?:No
Enumeration Date:2012-03-10
Last Update Date:2012-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR100591835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist