PRESTIGE PROFESSIONAL PHARMACY (NPI# 1144767427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144767427 |
| Entity Type | Organization |
| Organization Name | PRESTIGE PROFESSIONAL PHARMACY |
| Other Organization Name | PRESTIGE PROFESSIONAL PHARMACY |
| Practice Address |
11723 Ne Glisan St Portland OR 97220-2141 |
| Practice Telephone | 8666602626 |
| Practice Fax Number | 8882992770 |
| Mailing Telephone | 8666602626 |
| Mailing Fax Number | 8882992770 |
| Enumeration Date | 2017-01-25 |
| Last Update Date | 2019-02-27 |
| Authorized Official Name | CLOSE PHARMACY (OWNER/AO) |
| Authorized Official Telephone | 5035420733 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
RP0003251 | OR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2167382 | 01 |
| Other Name | Type Code |
|---|---|
| Prestige Professional Pharmacy | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | PRESTIGE PROFESSIONAL PHARMACY LLC | 11723 Ne Glisan St, Portland, OR 97220 |
| Street Address |
11723 NE GLISAN ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97220-2141 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316569254 | Debra Shamblin | Behavioral Analyst | 150 Ne 100th Ave, Portland, OR 97220 | 2020-05-14 |
| 1336780618 | Joan Lambert | Technician | 2802 Ne 108th Avenue, Portland, OR 97220 | 2019-10-08 |
| 1750933917 | Multnomah County | Clinic/Center | 11540 Ne Inverness Dr., Inverness Jail, Portland, OR 97220 | 2019-07-09 |
| 1194223107 | Landmark Connect of Oregon PC | General Practice | 5933 Ne Win Sivers Dr Ste 310, Portland, OR 97220 | 2018-01-24 |
| 1487178711 | Andrew Shonk | Massage Therapist | 163 Ne 102nd Ave Blid V, Portland, OR 97220 | 2017-07-28 |
| 1548781693 | Greater New Hope Family Services | Lodging | 11868 Ne Sandy Blvd, Portland, OR 97220 | 2017-06-29 |
| 1245771740 | Maria Teresa Banez Salcedo | Registered Nurse | 10300 Ne Hancock Street, Portland, OR 97220 | 2017-03-16 |
| 1568901858 | Christopher Gabriel Lyons | Adult Companion | 1343 Ne 118 Ave. Apt5, Portland, OR 97220 | 2017-02-20 |
| 1962945956 | Linda Ann Oldenburg | Registered Nurse | 9515 Ne Skidmore Avenue, Portland, OR 97220 | 2016-11-23 |
| 1326493446 | Trent D. Wilson | Massage Therapist | 8401 Ne Halsey St., Suite 101, Portland, OR 97220 | 2016-04-26 |
| Find all providers in zip 97220 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235747775 | Cordant Pharmacy Oregon, LLC | Pharmacy | 6135 Ne 80th Ave Ste A2, Portland, OR 97218-4033 | 2020-07-21 |
| 1578184909 | Capsule Portland LLC | Pharmacy | 416 Nw 12th Ave, Portland, OR 97209-2907 | 2020-04-27 |
| 1588291645 | Avita Drugs Oregon, LLC | Pharmacy | 2236 Se Belmont St Ste B, Portland, OR 97214-2817 | 2020-03-26 |
| 1649800186 | A & S Pharmacy LLC | Pharmacy | 1660 Wildcat Dr, Portland, TX 78374-2830 | 2020-01-23 |
| 1508337577 | Oregon Health & Science University | Pharmacy | 3303 Sw Bond Ave Rm 1090, Portland, OR 97239-4501 | 2018-12-17 |
| 1578049631 | Credena Health LLC | Pharmacy | 4805 Ne Glisan St Ste 11n321, Portland, OR 97213 | 2018-07-12 |
| 1538653654 | Division Pharmacy Inc. | Pharmacy | 10918 Se Division St, Portland, OR 97266-1259 | 2018-06-21 |
| 1659755593 | Portland Professional Pharmacy, LLC | Pharmacy | 11717 Ne Glisan St, Portland, OR 97220-2141 | 2015-07-09 |
| 1992194062 | Professionl Pharmacy | Pharmacy | 10000 Se Main St Ste 201, Portland, OR 97216-2448 | 2015-01-13 |
| 1932597978 | Pharmaca Integrative Pharmacy, Inc | Pharmacy | 240 Nw Lost Springs Terrace, Suite 36, Portland, OR 97229 | 2014-12-29 |
| Find all providers in PORTLAND | ||||
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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.