NPIMap

Organization Active NPI

Rogue Community Health

  • Community/Retail Pharmacy
  • Medford, OR
National Provider Identifier
1700609906
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
ROGUE COMMUNITY HEALTH
Practice address
19 Myrtle St
Medford, OR 97504-7337
Phone
(541) 842-7747
Fax
(541) 842-7637
NPI assigned
Nov 5, 2024
Last updated
Nov 5, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ROGUE COMMUNITY HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Authorized official

Name
Amy CervanNPI 1962619452
Title
Senior Director of Pharmacy
Phone
(541) 200-6859

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

19 Myrtle St
Medford, OR 97504-7337

Mailing address

19 Myrtle St
Medford, OR 97504-7337
Phone (541) 842-7747

Other names 2

  • Rogue Community Health Pharmacy Other name
  • Rogue Community Health Pharmacy R Other name

National Provider Directory

National Provider Directory
Tax ID family
Community Health Center16 organizations share this tax ID, including this one
Part of
Community Health Center

Other organizations with this tax ID 15

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

View all 15

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730764800000",
    "number": "1700609906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 MYRTLE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047337",
            "telephone_number": "541-842-7747",
            "fax_number": "541-842-7637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 MYRTLE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047337",
            "telephone_number": "541-842-7747",
            "fax_number": "541-842-7637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGUE COMMUNITY HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROGUE COMMUNITY HEALTH",
        "enumeration_date": "2024-11-05",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A",
        "authorized_official_last_name": "CERVAN",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "SENIOR DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "541-200-6859"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rogue Community Health Pharmacy",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Rogue Community Health Pharmacy R",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.