NPIMap

Organization Active NPI

Parko, Inc.

Doing business as Mac Prescription Shop

  • Community/Retail Pharmacy
  • McMinnville, OR
National Provider Identifier
1659360006
Registry record updated Mar 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
295 Issued in OR
Legal business name
PARKO, INC.
Doing business as
Mac Prescription Shop
Practice address
225 NE 3Rd St
McMinnville, OR 97128-4818
Phone
(503) 472-2146
Fax
(503) 435-1493
NPI assigned
Oct 18, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2011

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

Authorized official

Name
Mrs. Nicole Patrice Winnen, R.PH.NPI 1487662599
Title
President, Parko, Inc.
Phone
(503) 472-2146

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 295 OR Primary

Addresses

Primary practice location

225 NE 3Rd St
McMinnville, OR 97128-4818

Mailing address

225 NE 3Rd St
McMinnville, OR 97128-4818
Phone (503) 472-2146

Other identifiers 2

IdentifierTypeStateIssuer
119198MedicaidOR
3802572OtherNABP/NCPDP

Other names 1

  • Mac Prescription Shop Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120611000708 OR Part B Supplier - Mass Immunization (Roster Biller Only) 9032237755 Practice locations: McMinnville, OR

National Provider Directory

National Provider Directory
Tax ID family
Mac Prescription Shop2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

  • Parko Inc

    dba Mac Prescription Shop at PMC

    • Clinic Pharmacy
    • McMinnville, OR
    • NPI 1659621845
    NPD tax ID

Locations

225 NE 3rd St
McMinnville, OR 97128
Phone (503) 472-2146

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299110400000",
    "number": "1659360006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 NE 3RD ST",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971284818",
            "telephone_number": "503-472-2146",
            "fax_number": "503-435-1493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 NE 3RD ST",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971284818",
            "telephone_number": "503-472-2146",
            "fax_number": "503-435-1493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-18",
        "last_updated": "2011-03-03",
        "status": "A",
        "authorized_official_last_name": "WINNEN",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "PATRICE",
        "authorized_official_title_or_position": "PRESIDENT, PARKO, INC.",
        "authorized_official_telephone_number": "503-472-2146",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OR",
            "license": "295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119198",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP/NCPDP",
            "identifier": "3802572",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mac Prescription Shop",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in McMinnville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.