Active NPI
Kasprzyk Enterprises Inc
- Long Term Care Pharmacy
- Dallas, OR
National Provider Identifier
1235374877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- Legal business name
- KASPRZYK ENTERPRISES INC
- Practice address
- 289 E Ellendale Ave
Suite 402
Dallas, OR 97338-1580 - Phone
- (503) 623-5998
- NPI assigned
- Dec 11, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sandra Kasprzyk, RPH
- Title
- Owner
- Phone
- (503) 623-5998
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | OR | Primary |
Addresses
Primary practice location
289 E Ellendale Ave
Suite 402
Dallas, OR 97338-1580
Mailing address
289 E Ellendale Ave
Suite 402
Dallas, OR 97338-1580
Phone (503) 623-5998
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 092639 | Medicaid | OR |
Other names 1
- Medicine Shoppe
National Provider Directory
National Provider Directory- Tax ID family
- Kasprzyk Enterprises Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Durable Medical Equipment & Medical Supplies
- Dallas, OR
- NPI 1871738419
Locations
289 E Ellendale Ave
Ste 402
Dallas, OR 97338
Phone (503) 623-5998
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228953600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1228953600000",
"number": "1235374877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "289 E ELLENDALE AVE",
"address_2": "SUITE 402",
"city": "DALLAS",
"state": "OR",
"postal_code": "973381580",
"telephone_number": "503-623-5998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "289 E ELLENDALE AVE",
"address_2": "SUITE 402",
"city": "DALLAS",
"state": "OR",
"postal_code": "973381580",
"telephone_number": "503-623-5998"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KASPRZYK ENTERPRISES INC",
"organizational_subpart": "NO",
"enumeration_date": "2008-12-11",
"last_updated": "2008-12-11",
"status": "A",
"authorized_official_last_name": "KASPRZYK",
"authorized_official_first_name": "SANDRA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "503-623-5998",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": "OR",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "092639",
"state": "OR"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Medicine Shoppe",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Dallas, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.