Krasar Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

RP-0000297 Issued in OR

Legal business name

KRASAR INC

Practice address

218 SW Broadway St
Mill City, OR 97360-2411

Phone

(503) 897-2331

Fax

(503) 897-2332

NPI assigned

Feb 21, 2007

Organization subpart

No

Name

Randall Mickey, RPH

Title

Owner

Phone

(503) 897-2331

• MILL CITY PHARMACY Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 19, 2025.

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1053456392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 49",
            "city": "MILL CITY",
            "state": "OR",
            "postal_code": "97360",
            "telephone_number": "503-897-2331",
            "fax_number": "503-897-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 SW BROADWAY ST",
            "city": "MILL CITY",
            "state": "OR",
            "postal_code": "973602411",
            "telephone_number": "503-897-2331",
            "fax_number": "503-897-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRASAR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "MICKEY",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-897-2331",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OR",
            "license": "RP-0000297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109546",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2077896",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MILL CITY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lynn Eleanor-Johnson Gower, DO
• Johannah Marie Gregg, FNP-C
• Jessica Leigh Grim, FNP
• Christopher Kargel, DO, MPH
• Jerry Korkow, PSS
• Joseph Peter Lulich, FNP-C
• Cynthia Marion Peticolas, DMD
• Santiam Canyon School District 129J
• Santiam Memorial Hospital
• Santiam Memorial Hospital

• All providers in Mill City, OR
• Community/Retail Pharmacy in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.