NPIMap

Organization Active NPI

Providence Health & Services Oregon

Doing business as Providence Milwaukie Hosp Phcy

  • Pharmacy
  • Milwaukie, OR
National Provider Identifier
1598831133
Registry record updated Mar 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
RP0000827CS Issued in OR
Legal business name
PROVIDENCE HEALTH & SERVICES OREGON
Doing business as
Providence Milwaukie Hosp Phcy
Practice address
10150 SE 32ND Ave
Milwaukie, OR 97222-6516
Phone
(503) 513-8331
Fax
(503) 513-8324
NPI assigned
Nov 27, 2006
Last updated
Mar 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2013

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

Authorized official

Name
Suzanne Anthony, RPH
Title
Pharmacist in Charge
Phone
(503) 513-8381

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X RP0000827CS OR Primary

Addresses

Primary practice location

10150 SE 32ND Ave
Milwaukie, OR 97222-6516

Mailing address

10150 SE 32ND Ave
Milwaukie, OR 97222-6516
Phone (503) 513-8331

Other identifiers 2

IdentifierTypeStateIssuer
3802837OtherNCPDP PROVIDER IDENTIFICATION NUMBER
175620MedicaidOR

Other names 1

  • PROVIDENCE MILWAUKIE HOSP PHCY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
L E Stephens4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

10150 SE 32nd Ave
Portland, OR 97222
Phone (503) 215-4202

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362355200000",
    "number": "1598831133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10150 SE 32ND AVE",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972226516",
            "telephone_number": "503-513-8331",
            "fax_number": "503-513-8324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10150 SE 32ND AVE",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972226516",
            "telephone_number": "503-513-8331",
            "fax_number": "503-513-8324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTH & SERVICES OREGON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2013-03-04",
        "status": "A",
        "authorized_official_last_name": "ANTHONY",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "503-513-8381",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "OR",
            "license": "RP0000827CS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3802837",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175620",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROVIDENCE MILWAUKIE HOSP PHCY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Milwaukie, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2013; 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.