Organization Active NPI

Shamrock Medical Inc

  • Durable Medical Equipment & Medical Supplies
  • Portland, OR
National Provider Identifier
1316012768
Registry record updated Jun 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SHAMROCK MEDICAL INC
Practice address
3620 SE Powell Blvd
Portland, OR 97202-1880
Phone
(503) 233-5055
Fax
(503) 234-6974
NPI assigned
Nov 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2009

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

Authorized official

Name
Mrs. Lynda Jean Schwab
Title
Manager
Phone
(503) 233-5055

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

3620 SE Powell Blvd
Portland, OR 97202-1880

Mailing address

3620 SE Powell Blvd
Portland, OR 97202-1880
Phone (503) 233-5055

Other identifiers 2

IdentifierTypeStateIssuer
082081000OtherORREGENCE BLUE CROSS
207824MedicaidOR

National Provider Directory

National Provider Directory

Locations

3620 SE Powell Blvd
Portland, OR 97202
Phone (503) 233-5055

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245110400000",
    "number": "1316012768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 SE POWELL BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021880",
            "telephone_number": "503-233-5055",
            "fax_number": "503-234-6974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 SE POWELL BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021880",
            "telephone_number": "503-233-5055",
            "fax_number": "503-234-6974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAMROCK MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2009-06-16",
        "status": "A",
        "authorized_official_last_name": "SCHWAB",
        "authorized_official_first_name": "LYNDA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "503-233-5055",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE CROSS",
            "identifier": "082081000",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207824",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2009; 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.