NPIMap

Organization Active NPI

Central City Concern

Doing business as Old Town Clinic Pharmacy

  • Clinic Pharmacy
  • Portland, OR
National Provider Identifier
1114230331
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
RP0002607-CS Issued in OR
Legal business name
CENTRAL CITY CONCERN
Doing business as
Old Town Clinic Pharmacy
Practice address
727 W Burnside St
Portland, OR 97209-3514
Phone
(503) 944-4465
Fax
(971) 271-6124
NPI assigned
Jul 16, 2010
Last updated
Apr 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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

Authorized official

Name
Dr. Andrew B Mendenhall, MDNPI 1053347591
Title
President & Ceo
Phone
(503) 294-1681

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X RP0002607-CS OR Primary

Addresses

Primary practice location

727 W Burnside St
Portland, OR 97209-3514

Mailing address

121 NW Everett St
Portland, OR 97209-4049
Phone (503) 294-1681

Other names 1

  • Old Town Clinic Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Central City Concern Inc19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1279238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775692800000",
    "number": "1114230331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 NW EVERETT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972094049",
            "telephone_number": "503-294-1681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 W BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093514",
            "telephone_number": "503-944-4465",
            "fax_number": "971-271-6124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL CITY CONCERN",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-16",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A",
        "authorized_official_last_name": "MENDENHALL",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "503-294-1681",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "OR",
            "license": "RP0002607-CS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Old Town Clinic Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; 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.