NPIMap

Organization Active NPI

Benton County

  • Clinic Pharmacy
  • Corvallis, OR
National Provider Identifier
1689086381
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
RP0002882CS Issued in OR
Legal business name
BENTON COUNTY
Practice address
530 NW 27TH St
Corvallis, OR 97330-5223
Phone
(541) 766-2400
Fax
(541) 766-0110
NPI assigned
May 29, 2014
Last updated
May 1, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
BENTON COUNTYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Authorized official

Name
Lacey Mollel
Title
Health Department Director
Phone
(541) 766-6835

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X RP0002882 OR
Clinic Pharmacy 3336C0002X RP0002882CS OR Primary

Addresses

Primary practice location

530 NW 27TH St
Corvallis, OR 97330-5223

Mailing address

530 NW 27TH St
Corvallis, OR 97330-5223
Phone (541) 766-6835

Other identifiers 1

IdentifierTypeStateIssuer
3845053OtherNCPDP

Other names 1

  • Benton County Health Department Other name

National Provider Directory

National Provider Directory
Tax ID family
Benton County13 organizations share this tax ID, including this one
Part of
Benton County

Other organizations with this tax ID 12

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

NPI Registry JSON

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

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746057600000",
    "number": "1689086381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 NW 27TH ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973305223",
            "telephone_number": "541-766-6835",
            "fax_number": "541-766-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NW 27TH ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973305223",
            "telephone_number": "541-766-2400",
            "fax_number": "541-766-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENTON COUNTY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BENTON COUNTY",
        "enumeration_date": "2014-05-29",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A",
        "authorized_official_last_name": "MOLLEL",
        "authorized_official_first_name": "LACEY",
        "authorized_official_title_or_position": "HEALTH DEPARTMENT DIRECTOR",
        "authorized_official_telephone_number": "541-766-6835"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "OR",
            "license": "RP0002882",
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "OR",
            "license": "RP0002882CS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3845053",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Benton County Health Department",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Corvallis, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; 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.