Stayton Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

3805011 Issued in OR

Legal business name

STAYTON PHARMACY, LLC

Practice address

102 Martin Dr
Suite a
Stayton, OR 97383-1296

Phone

(503) 769-2616

Fax

(503) 769-9449

NPI assigned

Jul 21, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jamie Netland, R.PH

Title

Owner

Phone

(503) 769-2616

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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

• Chad Michael Jamison, CPHT

  • Pharmacy Technician
  • Stayton, OR
  • NPI 1215557186
  NPD (past)
• Melissa M Netland, RPH

  • Pharmacist
  • Stayton, OR
  • NPI 1154695385
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427932800000",
    "number": "1588685184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 MARTIN DR",
            "address_2": "SUITE A",
            "city": "STAYTON",
            "state": "OR",
            "postal_code": "973831296",
            "telephone_number": "503-769-2616",
            "fax_number": "503-769-9449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 MARTIN DR",
            "address_2": "SUITE A",
            "city": "STAYTON",
            "state": "OR",
            "postal_code": "973831296",
            "telephone_number": "503-769-2616",
            "fax_number": "503-769-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAYTON PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2015-04-02",
        "status": "A",
        "authorized_official_last_name": "NETLAND",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-769-2616",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OR",
            "license": "3805011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "297159",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210311",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meghan Dionndra Smith, DPT
• Christian Lee Spencer, P.A.
• Stayton Chiropractic, LLC
• Stayton Family Practice Inc
• Stayton Family Practice LLC
• Stayton SW Assisted Living LLC (Lakeside Assisted Living Community)
• Elizabeth Stefan, RPH
• Heather Stinger
• Henry Frank Storey, O.D.
• Nicolas J Stratton, M.D.

• Community/Retail Pharmacy in Stayton, OR
• Providers in Stayton, OR by specialty
• Community/Retail Pharmacy in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.