Provider Demographics
NPI:1518172469
Name:URIM, OLEG (RPH)
Entity type:Individual
Prefix:MR
First Name:OLEG
Middle Name:
Last Name:URIM
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 1:7 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01901-1206
Mailing Address - Country:US
Mailing Address - Phone:781-599-5900
Mailing Address - Fax:781-599-5918
Practice Address - Street 1:7 WILLOW ST
Practice Address - Street 2:FLAG PHARMACY
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1206
Practice Address - Country:US
Practice Address - Phone:781-599-5900
Practice Address - Fax:781-599-5918
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA23827183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist