Albany General Hospital

Organization Active NPI Community/Retail Pharmacy · Albany, OR

NPI 1548313356 · NPPES record last updated Nov 21, 2018

Key facts

NPI
1548313356
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
00104 (OR)
Legal business name
ALBANY GENERAL HOSPITAL
Practice address
1010 7TH Ave SW
Albany, OR 97321-1922
Phone
(541) 812-5071
NPI assigned
Jan 18, 2007
Organization subpart
No

Authorized official

Name
David Triebes, MBA
Title
Ceo
Phone
(541) 812-4102

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 195

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 195

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in OR

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Samaritan Evergreen Hospice
Albany, OR · CCN 381517
Hospice Operational/Managerial Control (100%) Jan 1, 2000

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20160928001921 OR Part B Supplier - Mass Immunization (Roster Biller Only) 9931097987 1 other NPI on this enrollment
Practice locations: Albany, OR
O20171226001783 OR Part B Supplier - Pharmacy 9931097987 1 other NPI on this enrollment
Practice locations: Albany, OR

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X 00104 OR Yes

Addresses

Primary practice location

1010 7TH Ave SW
Albany, OR 97321-1922

Mailing address

1010 7TH Ave SW
Albany, OR 97321-1922
Phone (541) 812-5071

Other identifiers

IdentifierTypeStateIssuer
RP-0000104-CSOtherORSTATE LICENSE

Other names

  • Elm Street Pharmacy Doing business as

Other providers in Albany, OR

All providers in Albany, OR · Community/Retail Pharmacy in Oregon

Sources for this page

Verify at the official NPI Registry.