J Mac Drug Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

0000563CS Issued in OR

Legal business name

J MAC DRUG INC

Practice address

15685 SW 116TH Ave
King City, OR 97224-2651

Phone

(503) 639-1171

Fax

(503) 620-2167

NPI assigned

Oct 7, 2006

Organization subpart

No

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

Authorized official

Name

Christina Cudahy, RPH

Title

Pharm MGR

Phone

(503) 639-7377

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• MCCANNS PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1160179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487635200000",
    "number": "1669569869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15685 SW 116TH AVE",
            "city": "KING CITY",
            "state": "OR",
            "postal_code": "972242651",
            "telephone_number": "503-639-1171",
            "fax_number": "503-620-2167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15685 SW 116TH AVE",
            "city": "KING CITY",
            "state": "OR",
            "postal_code": "972242651",
            "telephone_number": "503-639-1171",
            "fax_number": "503-620-2167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J MAC DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-07",
        "last_updated": "2017-02-21",
        "status": "A",
        "authorized_official_last_name": "CUDAHY",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "PHARM MGR",
        "authorized_official_telephone_number": "503-639-7377",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OR",
            "license": "0000563CS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123596",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2077240",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MCCANNS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anthony Dramov, PHARMD
• Amber Gatti Dunn, O.D.
• Gatti Vision LLC
• Hearing Healthcare Professionals of Oregon, LLC
• J Mac Drug Inc
• Brandon R Lewis
• Rachel Martel
• McCrae Management & Investments, LTD.
• Anthony Morant, RPH
• NS Hearing Network

• Community/Retail Pharmacy in King City, OR
• Providers in King City, 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 Feb 21, 2017; 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.