David Jorgensen

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

00182 Issued in OR

Legal business name

DAVID JORGENSEN

Practice address

1755 Coburg Rd
Eugene, OR 97401

Phone

(541) 343-8861

Fax

(541) 465-1392

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

David Jorgensen

Title

Owner

Phone

(541) 343-8861

Specialties & licenses 6

Addresses

Other identifiers 3

Other names 1

• Everetts Villa Pharmacy Doing business as

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1154433167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 COBURG RD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "97401",
            "telephone_number": "541-343-8861",
            "fax_number": "541-465-1392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 COBURG RD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "97401",
            "telephone_number": "541-343-8861",
            "fax_number": "541-465-1392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID JORGENSEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "JORGENSEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-343-8861"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OR",
            "license": "00182",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OR",
            "license": "00182",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "1180250001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170922",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3801657",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Everetts Villa Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Brooke Davalos, FNP-C, FNP-BC
• David a. Bove, ND PC
• David a. Lester, DDS, PC
• David H Ott DC PC
• David H. Ott, D. C. PC
• David Levin
• David S Miller MD
• Timothy Glenn David, PHARM D
• Craig J Davidson, M.D.
• John Robert Davidson, M.S.

• Community/Retail Pharmacy in Eugene, OR
• Providers in Eugene, 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 Mar 7, 2023; 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.