AVALINA PHARMACY INC (NPI# 1659857480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1659857480 |
Entity Type | Organization |
Organization Name | AVALINA PHARMACY INC |
Other Organization Name | AVALINA PHARMACY |
Practice Address |
3507 Commercial St Se Salem OR 97302 |
Practice Telephone | 5039021902 |
Practice Fax Number | 5039907629 |
Mailing Telephone | 5039021902 |
Mailing Fax Number | 5039907629 |
Enumeration Date | 2018-07-16 |
Last Update Date | 2019-09-24 |
NPI Deactivation Date | 05/17/2019 |
NPI Reactivation Date | 2019-07-17 |
Authorized Official Name | JOO HYEON KIM (PRESIDENT) |
Authorized Official Telephone | 5036860225 |
Authorized Official Credential | PHARM.D |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OR | 500761820 | 05 |
Other Name | Type Code |
---|---|
Avalina | Doing Business As Name - Organization |
Avalina Pharmacy | Doing Business As Name - Organization |
Address | Telephone Number | Fax Number |
---|---|---|
3509 Commercial St Se Ste 3507, Salem, OR 973023829 | 5418290115 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Oregon Corporations, Companies and Business Names | AVALINA PHARMACY INC. | 3507 Commercial St Se, Salem, OR 97302 |
Street Address |
3507 COMMERCIAL ST SE |
City | SALEM |
State | OR |
Zip Code | 97302 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952954679 | Eric Anthony Bohm | Pharmacist | 2757 22nd St. Se, Salem, OR 97302 | 2019-07-22 |
1598223737 | Michael Robert Martini | Counselor | 960 Liberty Rd Se Suite 120, Salem, OR 97302 | 2019-03-06 |
1649762733 | Joseph Bochsler | Physical Therapist | 3220 Liberty Rd. S., Salem, OR 97302 | 2018-06-04 |
1922533652 | Brianne Elizabeth Sischo | Licensed Practical Nurse | 3871 Fairview Industrial Dr. Se Ste, 150, Salem, OR 97302 | 2017-05-01 |
1851825566 | Modern Nose Clinic LLC | Otolaryngology | 340 Vista Ave Se, Ste 100, Salem, OR 97302 | 2017-04-19 |
1720529803 | Nicholas Forsberg | Massage Therapist | 126 Mize Rd S, Salem, OR 97302 | 2017-03-09 |
1437691078 | Kimo Mahi | Specialist/Technologist, Other | 2373 Kuebler Rd. S, Salem, OR 97302 | 2016-11-14 |
1588113278 | New Life Family Medicine LLC | Clinic/Center | 842 Commercial Street Ne, Salem, OR 97302 | 2016-09-23 |
1073060117 | Susan Morag Robnett | Counselor | 912 Fir Street South, Salem, OR 97302 | 2016-09-07 |
1952754442 | Nathan Patrick Johnson | Registered Nurse | 4035 12th St Cutoff Se Ste 120, Salem, OR 97302 | 2016-07-19 |
Find all providers in zip 97302 |
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 |
---|---|---|---|---|
1477027852 | Premier Pharmacy LLC | Pharmacy | 53 Stiles Rd Ste B102, Salem, NH 03079-2890 | 2019-01-18 |
1386090793 | Good Living Inc | Pharmacy | 1201 N Jim Day Rd Ste B, Suite B, Salem, IN 47167-7219 | 2016-05-05 |
1760859367 | Quisenberry Health System Pharmacy, LLC | Pharmacy | 148 Liberty St Se, Salem, OR 97301-3506 | 2015-08-31 |
1649306531 | Benignity LLC Dba Fort Lewis Pharmacy | Pharmacy | 2246 West Main St, Salem, VA 24153 | 2007-02-26 |
1316047749 | Cvs Pharmacy Inc | Pharmacy | 272 Highland Ave, Salem, MA 01970-1832 | 2006-09-25 |
1366542318 | Guffeys Pharmacy Inc | Pharmacy | 172 Hwy 62 E, Suite 2, Salem, AR 72576-0155 | 2006-09-22 |
1487753836 | Cvs Pharmacy Inc | Pharmacy | 200 Essex St, Salem, MA 01970-3705 | 2006-09-22 |
1730288184 | Cvs Pharmacy Inc | Pharmacy | 426b Essex St, Salem, MA 01970-3152 | 2006-09-22 |
1982707618 | Virginia Cvs Pharmacy, L.L.C. | Pharmacy | 179 Electric Rd, Salem, VA 24153-4432 | 2006-09-07 |
1205946837 | Costco Wholesale Corporation | Pharmacy | 1010 Hawthorne Ave Se, Salem, OR 97301 | 2006-08-30 |
Find all providers in SALEM |
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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.