Koreen Marie Sanders, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

0009398 Issued in OR

Practice address

601 W North St
Enterprise, OR 97828-1427

Phone

(541) 426-3535

Fax

(541) 426-9107

NPI assigned

Oct 22, 2010

Sex

Female

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Safeway Inc

  • Community/Retail Pharmacy
  • Enterprise, OR
  • NPI 1194754127
  NPD (past)
• Safeway Inc

  • Community/Retail Pharmacy
  • Queen Creek, AZ
  • NPI 1730040973
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 22, 2010.

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287705600000",
    "number": "1285934331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 W NORTH ST",
            "city": "ENTERPRISE",
            "state": "OR",
            "postal_code": "978281427",
            "telephone_number": "541-426-3535",
            "fax_number": "541-426-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W NORTH ST",
            "city": "ENTERPRISE",
            "state": "OR",
            "postal_code": "978281427",
            "telephone_number": "541-426-3535",
            "fax_number": "541-426-9107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "KOREEN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-22",
        "last_updated": "2010-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "0009398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Ruckdashel
• Jacqueline Marie Russell, PMHNP-BC
• Theresa A Russell, FNP
• Margaret J Rystrom, RN, CNL
• Safeway Inc
• Amanda Savage, LMT
• Angelina Schaeffer, RDH
• Christina Schaeffer, QMHA
• Tyler Boone Schaffeld, DMD
• Susanna Naomi Schauffler

• All providers in Enterprise, OR
• Pharmacist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2010; 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.