Basic Information
| Provider Information | |||||||||
| NPI: | 1255424446 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MOREHOUSE | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | B | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 424 FORTY NINER DRIVE | ||||||||
| Address2: | |||||||||
| City: | FRUITA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 81521 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702103744 | ||||||||
| FaxNumber: | 9708588931 | ||||||||
| Practice Location | |||||||||
| Address1: | 2121 NORTH AVE | ||||||||
| Address2: | |||||||||
| City: | GRAND JUNCTION | ||||||||
| State: | CO | ||||||||
| PostalCode: | 81501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702632822 | ||||||||
| FaxNumber: | 9702568900 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 12276 | CO | X | Pharmacy Service Providers | Pharmacist | 1835N1003X | 12276 | CO | X | Pharmacy Service Providers | Pharmacist | Nutrition Support | 1835P1200X | 12276 | CO | X | Pharmacy Service Providers | Pharmacist | Pharmacotherapy |
No ID Information.