Powell Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

RP0002838CS Issued in OR

Legal business name

POWELL PHARMACY, LLC

Practice address

11050 SE Powell Blvd Ste 375
Portland, OR 97266-1863

Phone

(818) 687-7368

NPI assigned

Nov 4, 2013

Organization subpart

No

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

Authorized official

Name

Gary Dontsov

Title

Managing Member

Phone

(818) 687-7368

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383523200000",
    "number": "1699104372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11050 SE POWELL BLVD STE 375",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972661863",
            "telephone_number": "818-687-7368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11050 SE POWELL BLVD STE 375",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972661863",
            "telephone_number": "818-687-7368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWELL PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-04",
        "last_updated": "2013-11-04",
        "status": "A",
        "authorized_official_last_name": "DONTSOV",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "818-687-7368"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OR",
            "license": "RP0002838CS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "RP0002838CS",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mastaneh Pournaderi, D.D.S
• Irene G. Powch, PH.D.
• Powell Dental P.C.
• Powell Dental Specialties
• Powell Family Dental
• Randi Lyn Powell Sexton, NP
• Kenneth Powell-Wilson
• Alice Karlin Powell, MA CLINICAL SOC WORK
• Ashley Powell
• Carolyn Powell, LPC

• Community/Retail Pharmacy in Portland, OR
• Providers in Portland, 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 Nov 4, 2013; 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.