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DR. DIEDERIK-JAN FREDERICK BOUWMEESTER PHARM.D.

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1568744233

Individual Registrant:
DR. DIEDERIK-JAN FREDERICK BOUWMEESTER PHARM.D.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
1065 S FORTUNA BLVD C/O WALGREENS PHARMACY FORTUNA, CA 95540-3010 US
Tel: 707-726-0377  Fax: 707-726-0383

Contact information for business:
PO BOX 8317  EUREKA, CA 95502-8317 US
Tel: 707-726-0377  Fax: --

Registration Information:
NPI: 1568744233
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
CA63614

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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