Provider Demographics
NPI:1962776195
Name:LAWRENCE, RICK WEAVER (RPH)
Entity type:Individual
Prefix:MR
First Name:RICK
Middle Name:WEAVER
Last Name:LAWRENCE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 DIVISION AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97404-5127
Mailing Address - Country:US
Mailing Address - Phone:541-461-1433
Mailing Address - Fax:541-461-1443
Practice Address - Street 1:60 DIVISION AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97404
Practice Address - Country:US
Practice Address - Phone:541-461-1433
Practice Address - Fax:541-461-1443
Is Sole Proprietor?:No
Enumeration Date:2012-03-06
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6440183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist