Individual provider Active NPI

Richard K. Lundgren, RPH

  • Pharmacist
  • Salem, OR
National Provider Identifier
1669759775
Registry record updated Nov 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
4955 Issued in OR
Practice address
890 Oak St SE
Suite 1090
Salem, OR 97301-3905
Phone
(503) 561-5325
Fax
(503) 561-4786
NPI assigned
Nov 3, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 4955 OR Primary

Addresses

Primary practice location

890 Oak St SE
Suite 1090
Salem, OR 97301-3905

Mailing address

890 Oak St SE
Suite 1090
Salem, OR 97301-3905
Phone (503) 561-5325

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
4955ORMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1320278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320278400000",
    "number": "1669759775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 OAK ST SE",
            "address_2": "SUITE 1090",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013905",
            "telephone_number": "503-561-5325",
            "fax_number": "503-561-4786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 OAK ST SE",
            "address_2": "SUITE 1090",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013905",
            "telephone_number": "503-561-5325",
            "fax_number": "503-561-4786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDGREN",
        "first_name": "RICHARD",
        "middle_name": "K.",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-03",
        "last_updated": "2011-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "4955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; 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.