Provider Demographics
NPI:1437968500
Name:ZEPEDA, GLORIA ALDRETE (PHARMD)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:ALDRETE
Last Name:ZEPEDA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 RIESSEN RD
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-9350
Mailing Address - Country:US
Mailing Address - Phone:541-441-6530
Mailing Address - Fax:
Practice Address - Street 1:1813 W HARVARD AVE STE 210
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471-2709
Practice Address - Country:US
Practice Address - Phone:541-229-1112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0020365183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist