Prestige Professional Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

RP0003251 Issued in OR

Legal business name

PRESTIGE PROFESSIONAL PHARMACY

Practice address

11723 NE Glisan St
Portland, OR 97220-2141

Phone

(866) 660-2626

Fax

(888) 299-2770

NPI assigned

Jan 25, 2017

Organization subpart

No

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

Authorized official

Name

Close Pharmacy

Title

Owner/Ao

Phone

(503) 542-0733

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Prestige Professional Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551225600000",
    "number": "1144767427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11723 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972202141",
            "telephone_number": "866-660-2626",
            "fax_number": "888-299-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11723 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972202141",
            "telephone_number": "866-660-2626",
            "fax_number": "888-299-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE PROFESSIONAL PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-25",
        "last_updated": "2019-02-27",
        "status": "A",
        "authorized_official_last_name": "PHARMACY",
        "authorized_official_first_name": "CLOSE",
        "authorized_official_title_or_position": "OWNER/AO",
        "authorized_official_telephone_number": "503-542-0733"
    },
    "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": "RP0003251",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2167382",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prestige Professional Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Prestige Professional Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Richard Dale Press, MD
• Sky Press, PA-S
• Peter Scott Pressman, M.D.
• Matthew Bradley Presson, DO
• Prestige in-Home Nursing Agency LLC
• Prestige Rehab Or LLC
• Presto Quality Care, Inc.
• Joyce Marie Preston-Kuntz, CRNA
• Adele Kelly Preston
• Aurora Maureen Preston

• Community/Retail Pharmacy in Portland, OR
• Providers in Portland, OR by specialty
• Community/Retail Pharmacy in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2019; 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.