ROSEBURG VAMC (NPI# 1003874546) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003874546 |
| Entity Type | Organization |
| Organization Name | ROSEBURG VAMC |
| Other Organization Name | ROSEBURG VAMC PHARMACY |
| Practice Address |
913 Nw Garden Valley Blvd Roseburg OR 97471-6523 |
| Mailing Address |
Po Box 94419 Cleveland OH 44101-4419 |
| Practice Telephone | 5414401000 |
| Practice Fax Number | 5414401204 |
| Mailing Telephone | 7023413164 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2019-09-05 |
| Authorized Official Name | ERIN DENISE POTTER (NPI TEAM MEMBER) |
| Authorized Official Telephone | 2023822579 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332100000X | Department of Veterans Affairs (VA) Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | NCPDP# | 3811862 | 01 |
| Other Name | Type Code |
|---|---|
| ROSEBURG VAMC PHARMACY | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841714607 | Roseburg Vamc | Clinic/Center | 211 E 7th Ave Ste 220, Eugene, OR 97401-2722 | 2017-08-02 |
| 1023061322 | Roseburg Vamc | Clinic/Center | 3355 Chad Drive, Eugene, OR 97408-7428 | 2006-05-18 |
| 1992756639 | Roseburg Vamc | Clinic/Center | 840 Railroad Street, Brookings, OR 97415-9998 | 2006-05-15 |
| 1235599614 | Roseburg Vamc | Department of Veterans Affairs (VA) Pharmacy | 3355 Chad Drive, Eugene, OR 97408-7428 | 2016-02-29 |
| 1841241932 | Roseburg Vamc | Clinic/Center | 2191 Marion St, North Bend, OR 97459-2314 | 2006-05-13 |
| 1174572549 | Roseburg Vamc | General Acute Care Hospital | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6523 | 2006-05-10 |
| Street Address |
913 NW GARDEN VALLEY BLVD |
| City | ROSEBURG |
| State | OR |
| Zip Code | 97471-6523 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114525607 | Kenny Duong | Pharmacist | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6523 | 2020-10-15 |
| 1588262521 | Ayman Alholail | Pharmacist | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6523 | 2020-10-12 |
| 1194332528 | Carrie Webster | Psychologist | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6523 | 2020-09-29 |
| 1619580776 | Shane Gamble | Dietitian, Registered | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6523 | 2020-08-28 |
| 1942811658 | Shannon O'leary | Pharmacist | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6523 | 2020-08-14 |
| 1215554209 | Joseph Albrecht | Dietitian, Registered | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6523 | 2020-06-25 |
| 1609402601 | Crystal Marie Leatherman | Dietitian, Registered | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6513 | 2020-03-21 |
| 1477189710 | Foua Xiong | Pharmacist | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6523 | 2020-03-18 |
| 1700425741 | Leah Isip | Pharmacist | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6523 | 2019-12-21 |
| 1598306060 | Anna Alexandra Jadanova | Psychologist | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6523 | 2019-10-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841805660 | Rae Ann Barnes | Pharmacist | 913 Ne Garden Valley Blvd, Pharmacy, Roseburg, OR 97471 | 2020-09-09 |
| 1023651031 | Colton Phillips | Behavioral Analyst | 940 Nw Garden Valley Bvld #104, Roseburg, OR 97471 | 2019-10-22 |
| 1952884876 | Meredith Krugel Lcsw PC | Clinic/Center | 2225 Nw Stewart Parkway Ste 200, Roseburg, OR 97471 | 2018-09-07 |
| 1114456563 | Philip Kaser Family, LLC | Pharmacy | 1175 W. Harvard Avenue, Roseburg, OR 97471 | 2017-06-08 |
| 1053854208 | Icco LLC | Clinic/Center | 1740 Nw Goetz Street, Roseburg, OR 97471 | 2016-11-21 |
| 1770034589 | Evie Jepsen | Case Manager/Care Coordinator | 2700 Stewart Parkway Annex B, Suite 110, Roseburg, OR 97471 | 2016-10-17 |
| 1932551256 | Jonathan Schmidt | Licensed Practical Nurse | 913 Nm Garden Valley Blvd, Va Roseburg Medical Center, Roseburg, OR 97471 | 2016-07-11 |
| 1932580586 | Jeffrey Mark Wareham | Case Manager/Care Coordinator | 2700 Medical Loop, Annex B, Roseburg, OR 97471 | 2015-06-09 |
| 1558784215 | Ginger Jean Thibedeau | Massage Therapist | 3019 Nw Stewart Parkway, Suite 304 #183, Roseburg, OR 97471 | 2014-01-30 |
| 1427303122 | Karishma Parekh | Internal Medicine | 2460 Nw Stewart Pkwy Ste 103, Roseburg, OR 97471 | 2012-07-18 |
| Find all providers in zip 97471 | ||||
| Taxonomy Code | 332100000X |
| Grouping | Suppliers |
| Classification | Department of Veterans Affairs (VA) Pharmacy |
| Department of Veterans Affairs (VA) Pharmacy means any place under VA jurisdiction where drugs are dispensed and Pharmaceutical Care is provided to enrolled Veterans, by licensed pharmacists. The Pharmacy is reviewed by JCAHO, utilizes the VA hospital’s DEA number, and has a designated NCPDP number. VA facility pharmacies include Inpatient (Institutional), Outpatient, Consolidated Mail Outpatient Pharmacies (CMOPs), Research, Addiction Treatment Centers, Long Term Care and Community Based Outpatient Clinics Pharmacies. The VHA Pharmacy Benefits Management - Strategic Healthcare Group has oversight for professional and practice activities of VA Pharmacies. Each pharmacy is under the direct supervision of a U.S. or U.S. territory licensed pharmacist, and has staffing to meet its designated scope of service. |
| Notes: Source: Pharmacy Benefits Management – Strategic Healthcare Group, Veterans Health Administration, Department of Veterans Affairs [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235599614 | Roseburg Vamc | Department of Veterans Affairs (VA) Pharmacy | 3355 Chad Drive, Eugene, OR 97408-7428 | 2016-02-29 |
| 1700834900 | White City Vamc | Department of Veterans Affairs (VA) Pharmacy | 8495 Crater Lake Hwy, White City, OR 97503-3011 | 2006-05-04 |
| 1306804588 | Portland Vamc | Department of Veterans Affairs (VA) Pharmacy | 3710 Sw Us Veterans Hospital Rd, Portland, OR 97239-2964 | 2006-05-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.