OREGON CVS PHARMACY LLC (NPI# 1568484285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568484285 |
| Entity Type | Organization |
| Organization Name | OREGON CVS PHARMACY LLC |
| Other Organization Name | CVS PHARMACY #16159 |
| Practice Address |
2000 Crater Lake Hwy Medford OR 97504-4161 |
| Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 5417795110 |
| Practice Fax Number | 5417795110 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2016-11-18 |
| Authorized Official Name | SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | RP-0002055 | OR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2079234 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #16159 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881209385 | Oregon Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 12555 Nw Cornell Rd, Portland, OR 97229-5683 | 2020-09-11 |
| 1386294379 | Oregon Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 8145 Se 17th Ave, Portland, OR 97202-6718 | 2019-09-12 |
| 1346899721 | Oregon Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 345 Sw Harrison St, Portland, OR 97201-5364 | 2019-09-09 |
| 1588140321 | Oregon Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3031 Se Powell Blvd, Portland, OR 97202-1955 | 2018-07-16 |
| 1588008312 | Oregon Cvs Pharmacy LLC | Pharmacy | 939 Sw Morrison St, Portland, OR 97205-2727 | 2013-04-23 |
| 1467708214 | Oregon Cvs Pharmacy LLC | Pharmacy | 1555 N Tomahawk Island Dr, Portland, OR 97217-7912 | 2012-07-31 |
| 1306078035 | Oregon Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 9401 Ne Cascades Pkwy, Portland, OR 97220-6824 | 2009-08-13 |
| 1619125614 | Oregon Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 9000 Se Sunnyside Rd, Clackamas, OR 97015-9758 | 2008-09-03 |
| 1194747816 | Oregon Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2750 Gateway St, Springfield, OR 97477-1172 | 2006-07-24 |
| 1992727614 | Oregon Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2255 14th Ave Se, Albany, OR 97322-8513 | 2006-07-24 |
| Street Address |
2000 CRATER LAKE HWY |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-4161 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154955359 | Brandon Berioso | Pharmacist | 2000 Crater Lake Hwy, Medford, OR 97504-4161 | 2020-02-26 |
| 1972916492 | Loren Podoll | Pharmacist | 2000 Crater Lake Hwy, Medford, OR 97504-4161 | 2014-06-03 |
| 1891121596 | Brittany Brooks Lapham | Pharmacist | 2000 Crater Lake Hwy, Medford, OR 97504-4161 | 2013-09-25 |
| 1427336577 | Braxton Tristan Michael Mehl | Pharmacist | 2000 Crater Lake Hwy, T-0613, Medford, OR 97504-4161 | 2011-07-22 |
| 1003103631 | Mark K Williams | Pharmacist | 2000 Crater Lake Hwy, T-00613, Medford, OR 97504-4161 | 2011-07-04 |
| 1124315973 | Rudolf Dickeinstein Tanga | Pharmacist | 2000 Crater Lake Hwy, T0613, Medford, OR 97504-4161 | 2011-06-30 |
| 1962796144 | Sharon Dillingham | Pharmacist | 2000 Crater Lake Hwy, Medford, OR 97504-4161 | 2011-06-05 |
| 1982721833 | Michael D. Gilbert | Pharmacist | 2000 Crater Lake Hwy, Medford, OR 97504-4161 | 2007-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598186595 | Pharmacy 112 Inc. | Pharmacy | 2608 Route 112 # B, Medford, NY 11763-2551 | 2013-12-18 |
| 1669721239 | Medford Compounding & Specialty Pharmacy LLC | Pharmacy | 2612 Route 112, Medford, NY 11763-2522 | 2012-08-29 |
| 1255623401 | Downtown Pharmacy Inc. | Pharmacy | 3528 Lone Pine Rd # 2, Medford, OR 97504-5668 | 2011-05-06 |
| 1063682805 | Wellness Compounding Pharmacy | Pharmacy | 522 Crater Lake Ave, Medford, OR 97504-6810 | 2008-03-07 |
| 1235236175 | Kennedy Drug Co | Pharmacy | 107 E Cherokee St, Medford, OK 73759-1209 | 2006-09-20 |
| 1275545857 | Shore Pharmacy | Pharmacy | 429 High St, Medford, MA 02155-3632 | 2006-08-12 |
| 1073545943 | Stop and Shop Supermarket Co LLC | Pharmacy | 760 Fellsway, Medford, MA 02155-4926 | 2006-07-07 |
| 1609808559 | Stop and Shop Supermarket Co LLC | Pharmacy | 70030 Patchogue Yaphank Road, Medford, NY 11763 | 2006-07-07 |
| 1174568562 | Fred Meyer Stores Inc | Pharmacy | 1301 Center Dr, Medford, OR 97501-7938 | 2006-06-18 |
| 1659312023 | Downtown Pharmacy Inc | Pharmacy | 333 N Riverside Ave, Medford, OR 97501-5937 | 2006-06-09 |
| Find all providers in MEDFORD | ||||
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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.