Individual provider Active NPI

Alfred Thomas Abrahamsen, PHARMD

  • Pharmacist
  • Coos Bay, OR
National Provider Identifier
1376843987
Registry record updated Dec 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
12252 Issued in OR
Practice address
230 E Johnson Ave
Coos Bay, OR 97420-1478
Phone
(541) 267-1709
Fax
(541) 267-1712
NPI assigned
Oct 28, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 12252 OR Primary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 12252 OR

Addresses

Primary practice location

230 E Johnson Ave
Coos Bay, OR 97420-1478

Mailing address

230 E Johnson Ave
Coos Bay, OR 97420-1478
Phone (541) 267-1709

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
12252ORMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1288224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450915200000",
    "number": "1376843987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 E JOHNSON AVE",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974201478",
            "telephone_number": "541-267-1709",
            "fax_number": "541-267-1712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 E JOHNSON AVE",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974201478",
            "telephone_number": "541-267-1709",
            "fax_number": "541-267-1712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAMSEN",
        "first_name": "ALFRED",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-28",
        "last_updated": "2015-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "12252",
            "primary": true
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OR",
            "license": "12252",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coos Bay, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2015; 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.