Organization Active NPI

Kasprzyk Enterprises Inc

  • Long Term Care Pharmacy
  • Dallas, OR
National Provider Identifier
1235374877
Registry record updated Dec 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
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

Updated by the provider on Dec 11, 2008

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
092639MedicaidOR

Other names 1

  • Medicine Shoppe Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kasprzyk Enterprises Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

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.

Verify at the official NPI Registry.