NPIMap

Organization Active NPI

Hollywood Pharmacy Inc

  • Durable Medical Equipment & Medical Supplies
  • Salem, OR
National Provider Identifier
1497990097
Registry record updated Dec 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
HOLLYWOOD PHARMACY INC
Practice address
1890 Capitol St NE
Salem, OR 97301-7859
Phone
(503) 364-4436
NPI assigned
Dec 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2008

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

Authorized official

Name
Sandra Kasprzyk, RPH
Title
Owner
Phone
(503) 364-4436

Specialties & licenses 1

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

Addresses

Primary practice location

1890 Capitol St NE
Salem, OR 97301-7859

Mailing address

1890 Capitol St NE
Salem, OR 97301-7859

Other identifiers 1

IdentifierTypeStateIssuer
292935MedicaidOR

Other names 1

  • Medicine Shoppe Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Hollywood Pharmacy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1228867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228867200000",
    "number": "1497990097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 CAPITOL ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973017859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 CAPITOL ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973017859",
            "telephone_number": "503-364-4436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLYWOOD PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-10",
        "last_updated": "2008-12-10",
        "status": "A",
        "authorized_official_last_name": "KASPRZYK",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-364-4436",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292935",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicine Shoppe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2008; 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.