NPIMap

Organization Active NPI

Wilson Drug Inc

Doing business as Tillamook Pharmacy

  • Community/Retail Pharmacy
  • Tillamook, OR
National Provider Identifier
1255477865
Registry record updated Sep 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
RP-0000561 Issued in OR
Legal business name
WILSON DRUG INC
Doing business as
Tillamook Pharmacy
Practice address
915 Main Ave
Tillamook, OR 97141-3815
Phone
(503) 842-4181
Fax
(503) 842-1147
NPI assigned
Jan 30, 2007
Last updated
Sep 28, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2016

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

Authorized official

Name
David WilsonNPI 1851800577
Title
Owner
Phone
(503) 842-4181

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X RP-0000561 OR Primary

Addresses

Primary practice location

915 Main Ave
Tillamook, OR 97141-3815

Mailing address

915 Main Ave
Tillamook, OR 97141-3815
Phone (503) 842-4181

Other identifiers 2

IdentifierTypeStateIssuer
182365MedicaidOR
2077217OtherPK

Other names 1

  • TILLAMOOK PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

915 Main Ave
Tillamook, OR 97141
Phone (503) 842-4181

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475020800000",
    "number": "1255477865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 MAIN AVE",
            "city": "TILLAMOOK",
            "state": "OR",
            "postal_code": "971413815",
            "telephone_number": "503-842-4181",
            "fax_number": "503-842-1147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 MAIN AVE",
            "city": "TILLAMOOK",
            "state": "OR",
            "postal_code": "971413815",
            "telephone_number": "503-842-4181",
            "fax_number": "503-842-1147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2016-09-28",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-842-4181"
    },
    "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": "RP-0000561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182365",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2077217",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TILLAMOOK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tillamook, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2016; 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.