Active NPI
Brandon Cole Toulis
- Community/Retail Pharmacy
- Portland, OR
National Provider Identifier
1649984386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 0019303
- Practice address
- 345 SW Harrison St
Portland, OR 97201-5364 - Phone
- (503) 327-0234
- NPI assigned
- Jan 9, 2023
- Last updated
- Jan 9, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 0019303 | OR | Primary |
Addresses
Primary practice location
345 SW Harrison St
Portland, OR 97201-5364
Mailing address
77 NW Hermosa Blvd
Portland, OR 97210-3841
Phone (863) 673-6640
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0019303 | OR | MD | Community/Retail Pharmacy |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oregon CVS Pharmacy LLC | Community/Retail Pharmacy | Current | Accepting new patients |
| Oregon CVS Pharmacy LLC | Community/Retail Pharmacy | Past | Accepting new patients |
Locations
345 SW Harrison St
Portland, OR 97201
Phone (503) 327-0234
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673222400000",
"number": "1649984386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "77 NW HERMOSA BLVD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972103841",
"telephone_number": "863-673-6640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "345 SW HARRISON ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972015364",
"telephone_number": "503-327-0234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOULIS",
"first_name": "BRANDON",
"middle_name": "COLE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-01-09",
"last_updated": "2023-01-09",
"certification_date": "2023-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "OR",
"license": "0019303",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.