NPIMap

Organization Active NPI

Mid Valley Healthcare Inc

Doing business as Samaritan Pharmacy - Sweet Home

  • Community/Retail Pharmacy
  • Sweet Home, OR
National Provider Identifier
1205524691
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
MID VALLEY HEALTHCARE INC
Doing business as
Samaritan Pharmacy - Sweet Home
Practice address
1289 49TH Ave Suite 104
Sweet Home, OR 97386
Phone
(541) 451-7471
NPI assigned
Apr 25, 2023
Last updated
Sep 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Authorized official

Name
Joseph M. Cahill III
Title
Ceo-SLCH
Phone
(541) 451-7914

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1289 49TH Ave Suite 104
Sweet Home, OR 97386

Mailing address

PO Box 1189
Corvallis, OR 97339-1189
Phone (541) 768-4410

Other names 1

  • Samaritan Pharmacy - Sweet Home Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160920001328 OR Part B Supplier - Mass Immunization (Roster Biller Only) 2769391523 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lebanon, OR; Sweet Home, OR
O20180110001367 OR Part B Supplier - Pharmacy 2769391523 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lebanon, OR; Sweet Home, OR

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Lebanon Emergency Physi12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

1289 49th Ave
Ste 104
Sweet Home, OR 97386
Phone (541) 451-7471

NPI Registry JSON

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

{
    "created_epoch": "1682380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694649600000",
    "number": "1205524691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189",
            "telephone_number": "541-768-4410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1289 49TH AVE SUITE 104",
            "city": "SWEET HOME",
            "state": "OR",
            "postal_code": "97386",
            "telephone_number": "541-451-7471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID VALLEY HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-25",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A",
        "authorized_official_last_name": "CAHILL",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CEO-SLCH",
        "authorized_official_telephone_number": "541-451-7914",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Samaritan Pharmacy - Sweet Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Samaritan Pharmacy - Sweet Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sweet Home, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.