NPIMap

Organization Active NPI

Waterfall Community Health Center

Doing business as Waterfall Community Pharmacy

  • Federally Qualified Health Center (FQHC)
  • Eagle Point, OR
National Provider Identifier
1730564386
Registry record updated Jul 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
7062 Issued in OR
Legal business name
WATERFALL COMMUNITY HEALTH CENTER
Doing business as
Waterfall Community Pharmacy
Practice address
2299 Butte Falls Hwy
Eagle Point, OR 97524-4463
Phone
(541) 951-7723
NPI assigned
Jul 24, 2015
Last updated
Jul 11, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2017

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

Authorized official

Name
Mrs. Andrea Trenner
Title
Ceo
Phone
(541) 756-6232

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 7062 OR Primary

Addresses

Primary practice location

2299 Butte Falls Hwy
Eagle Point, OR 97524-4463

Mailing address

2299 Butte Falls Hwy
Eagle Point, OR 97524-4463
Phone (541) 951-7723

Other names 1

  • Waterfall Community Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Waterfall Community Health Center8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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.

  • Zane Smith
    • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
    • Eagle Point, OR
    • NPI 1649630591
    NPD (past)

NPI Registry JSON

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

{
    "created_epoch": "1437696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499731200000",
    "number": "1730564386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2299 BUTTE FALLS HWY",
            "city": "EAGLE POINT",
            "state": "OR",
            "postal_code": "975244463",
            "telephone_number": "541-951-7723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2299 BUTTE FALLS HWY",
            "city": "EAGLE POINT",
            "state": "OR",
            "postal_code": "975244463",
            "telephone_number": "541-951-7723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERFALL COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-24",
        "last_updated": "2017-07-11",
        "status": "A",
        "authorized_official_last_name": "TRENNER",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-756-6232",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "OR",
            "license": "7062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waterfall Community Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eagle Point, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.