Specialty Compounding Pharmacy LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

RP0003230CS Issued in OR

Legal business name

SPECIALTY COMPOUNDING PHARMACY LLC

Practice address

9150 SW Pioneer CT Ste F
Wilsonville, OR 97070-9623

Phone

(503) 582-1776

Fax

(503) 466-3098

NPI assigned

Nov 4, 2016

Last updated

Mar 10, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Richard White

Title

Owner

Phone

(503) 582-1776

Specialties & licenses 4

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1478217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489104000000",
    "number": "1518409788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9150 SW PIONEER CT STE F",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709623",
            "telephone_number": "503-582-1776",
            "fax_number": "503-466-3098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9150 SW PIONEER CT STE F",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709623",
            "telephone_number": "503-582-1776",
            "fax_number": "503-466-3098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY COMPOUNDING PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-04",
        "last_updated": "2017-03-10",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-582-1776"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "OR",
            "license": "RP0003230CS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2168204",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Elizabeth Sodaro, L.AC
• Theresa Corina Solis, LMT
• Jesus Manuel Soltero-Plaza, PT, DPT
• Heejoo Song
• Joan Specht, MA-CCC/SLP
• Specialty Pharmcy, Inc
• Emily Noelle Speier
• Kristine J Spencer, PT
• Kayla Renea Spicer, LMT
• Robert Spiegel, RN, BSN, CHPN

• Compounding Pharmacy in Wilsonville, OR
• Providers in Wilsonville, OR by specialty
• Compounding Pharmacy in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2017; 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.