Organization Active NPI

Ashland Drug Inc.

  • Pharmacy
  • Ashland, OR
National Provider Identifier
1386632214
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
00111 Issued in OR
Legal business name
ASHLAND DRUG INC.
Practice address
53 N. Second St.
Ashland, OR 97520
Phone
(541) 482-3366
Fax
(541) 482-2736
NPI assigned
Oct 13, 2005
Last updated
Apr 14, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

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

Authorized official

Name
Christopher Fidel Hernandez
Title
Owner
Phone
(541) 482-3366

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 00111 OR Primary

Addresses

Primary practice location

53 N. Second St.
Ashland, OR 97520

Mailing address

53 N. Second St.
Ashland, OR 97520
Phone (541) 482-3366

Other identifiers 3

IdentifierTypeStateIssuer
170160MedicaidOR
816033000OtherORREGENCE BLUE CROSS BLUE S
0380084-02OtherORREGENCE HMO OREGON

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120124000228 OR Part B Supplier - Mass Immunization (Roster Biller Only) 3870612724 Practice locations: Ashland, OR

National Provider Directory

National Provider Directory

Locations

275 E Main St
Ashland, OR 97520
Phone (541) 482-3366

53 N 2nd St
Ashland, OR 97520
Phone (541) 428-3366

Practitioners & affiliated clinicians

Practitioners 3

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": "1129161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618358400000",
    "number": "1386632214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 N. SECOND ST.",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "97520",
            "telephone_number": "541-482-3366",
            "fax_number": "541-482-2736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 N. SECOND ST.",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "97520",
            "telephone_number": "541-482-3366",
            "fax_number": "541-482-2736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASHLAND DRUG INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-13",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "FIDEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-482-3366"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "OR",
            "license": "00111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170160",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE CROSS BLUE S",
            "identifier": "816033000",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE HMO OREGON",
            "identifier": "0380084-02",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.