NPIMap

Organization Active NPI

Oregon CVS Pharmacy LLC

Doing business as CVS Pharmacy #16126

  • Pharmacy
  • Tigard, OR
National Provider Identifier
1104848829
Registry record updated Dec 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
RP-0001657 Issued in OR
Legal business name
OREGON CVS PHARMACY LLC
Doing business as
CVS Pharmacy #16126
Practice address
9009 SW Hall Blvd
Tigard, OR 97223-4432
Phone
(503) 639-3446
Fax
(503) 207-7176
NPI assigned
Jul 24, 2006
Last updated
Dec 9, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Susan Colbert
Title
Sr. Director, Payer Relations
Phone
(401) 770-2751

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X RP-0001657 OR Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

9009 SW Hall Blvd
Tigard, OR 97223-4432

Mailing address

1 CVS Dr
Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500

Other names 1

  • CVS Pharmacy #16126 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20161118000149 OR DME Supplier - Pharmacy 3476841768 Practice locations: Tigard, OR
O20170104001867 OR Part B Supplier - Mass Immunization (Roster Biller Only) 3476841768 40 other NPIs on this enrollment
Practice locations: Portland, OR; Salem, OR; Sherwood, OR; Springfield, OR; Tigard, OR; Wilsonville, OR; Albany, OR; Beaverton, OR…

Other NPIs on the same Medicare enrollment 36

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 36

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
CVS Pharmacy #161269009 SW Hall Blvd, Tigard, OR 97223(503) 639-3446 Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Ostomy Supplies|Urologic… Accepts assignmentParticipating since Jan 1, 2023

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481241600000",
    "number": "1104848829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "BOX 1075",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146",
            "telephone_number": "401-765-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9009 SW HALL BLVD",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972234432",
            "telephone_number": "503-639-3446",
            "fax_number": "503-207-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON CVS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2016-12-09",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "SR. DIRECTOR, PAYER RELATIONS",
        "authorized_official_telephone_number": "401-770-2751"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "OR",
            "license": "RP-0001657",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy #16126",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.