NPIMap

Organization Active NPI

Peacehealth Networks on Demand, LLC

Doing business as ZoomCare-Broadway & 33rd

  • Non-Pharmacy Dispensing Site
  • Portland, OR
National Provider Identifier
1407466865
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
PEACEHEALTH NETWORKS ON DEMAND, LLC
Doing business as
ZoomCare-Broadway & 33rd
Practice address
3218 NE Broadway St
Portland, OR 97232-1815
Phone
(503) 941-3807
Fax
(503) 941-3809
NPI assigned
Jul 31, 2020
Last updated
Jul 31, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
PEACEHEALTH NETWORKS ON DEMANDS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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

Authorized official

Name
Dr. Mallory Alyse Kempton-Hein, PHARM D.NPI 1366948465
Title
Pharmacist
Phone
(503) 941-3807

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

3218 NE Broadway St
Portland, OR 97232-1815

Mailing address

1455 NW Irving St Ste 600
Portland, OR 97209-2277
Phone (503) 941-3807

Other identifiers 1

IdentifierTypeStateIssuer
0000028-CSOtherORSUPERVISING PHYSICIAN DISPENSING OUTLET

Other names 1

  • ZoomCare-Broadway & 33rd Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Peacehealth Networks62 organizations share this tax ID, including this one
Part of
Peacehealth Networks

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

3218 NE Broadway St
Portland, OR 97232

Practitioners & affiliated clinicians

Practitioners 1

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": "1596153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596153600000",
    "number": "1407466865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 NW IRVING ST STE 600",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092277",
            "telephone_number": "503-941-3807",
            "fax_number": "503-941-3809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3218 NE BROADWAY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321815",
            "telephone_number": "503-941-3807",
            "fax_number": "503-941-3809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACEHEALTH NETWORKS ON DEMAND, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEACEHEALTH NETWORKS ON DEMANDS, LLC",
        "enumeration_date": "2020-07-31",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A",
        "authorized_official_last_name": "KEMPTON-HEIN",
        "authorized_official_first_name": "MALLORY",
        "authorized_official_middle_name": "ALYSE",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "503-941-3807",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM D."
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUPERVISING PHYSICIAN DISPENSING OUTLET",
            "identifier": "0000028-CS",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ZoomCare-Broadway & 33rd",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 31, 2020; 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.