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DR. DIEDERIK-JAN FREDERICK BOUWMEESTER PHARM.D.
>> Pharmacist >> Pharmacy Service ProvidersRegistrant NPI Number: 1568744233
Individual Registrant:DR. DIEDERIK-JAN FREDERICK BOUWMEESTER PHARM.D.
Gender: M
Not Sole Proprietor
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
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: --
Tel: 707-726-0377 Fax: --
Registration Information:
NPI: 1568744233
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 183500000X | Pharmacy Service Providers Pharmacist | CA | 63614 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
