NPIMap

Organization Active NPI

Winding Waters Medical Clinic

Doing business as Enterprise Pharmacy of Winding Waters

  • Community/Retail Pharmacy
  • Enterprise, OR
National Provider Identifier
1285482695
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
WINDING WATERS MEDICAL CLINIC
Doing business as
Enterprise Pharmacy of Winding Waters
Practice address
501 W North St
Enterprise, OR 97828-1044
Phone
(541) 426-4502
Fax
(541) 426-6403
NPI assigned
May 9, 2024
Last updated
May 9, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
WINDING WATERS MEDICAL CLINICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Authorized official

Name
Keli Jean Dennis
Title
Coo
Phone
(541) 426-4502

Specialties & licenses 1

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

Addresses

Primary practice location

501 W North St
Enterprise, OR 97828-1044

Mailing address

603 Medical Pkwy
Enterprise, OR 97828-5124
Phone (541) 426-4502

Other names 1

  • Enterprise Pharmacy of Winding Waters Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Winding Waters Medical Clin6 organizations share this tax ID, including this one
Part of
Winding Waters Medical Clin

Other organizations with this tax ID 5

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

Locations

501 W North St
Enterprise, OR 97828

NPI Registry JSON

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

{
    "created_epoch": "1715212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715212800000",
    "number": "1285482695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 MEDICAL PKWY",
            "city": "ENTERPRISE",
            "state": "OR",
            "postal_code": "978285124",
            "telephone_number": "541-426-4502",
            "fax_number": "541-426-6403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W NORTH ST",
            "city": "ENTERPRISE",
            "state": "OR",
            "postal_code": "978281044",
            "telephone_number": "541-426-4502",
            "fax_number": "541-426-6403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINDING WATERS MEDICAL CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WINDING WATERS MEDICAL CLINIC",
        "enumeration_date": "2024-05-09",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A",
        "authorized_official_last_name": "DENNIS",
        "authorized_official_first_name": "KELI",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "541-426-4502"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Enterprise Pharmacy of Winding Waters",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Enterprise, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; 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.