Managed Health Care of Oregon I LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

IP0001181CS Issued in OR

Legal business name

MANAGED HEALTH CARE OF OREGON I LLC

Doing business as

Managed Healthcare of Or LLC

Practice address

1825 Maple St
Forest Grove, OR 97116-1939

Phone

(503) 357-8442

Fax

(503) 992-0722

NPI assigned

Jan 3, 2007

Organization subpart

No

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

Authorized official

Name

Christopher Vorrath

Title

Owner and MGR

Phone

(503) 357-8442

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• MANAGED HEALTHCARE OF OR LLC Doing business as

Locations

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376265600000",
    "number": "1750448130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 MAPLE ST",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971161939",
            "telephone_number": "503-357-8442",
            "fax_number": "503-992-0722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 MAPLE ST",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971161939",
            "telephone_number": "503-357-8442",
            "fax_number": "503-992-0722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANAGED HEALTH CARE OF OREGON I LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2013-08-12",
        "status": "A",
        "authorized_official_last_name": "VORRATH",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER AND MGR",
        "authorized_official_telephone_number": "503-357-8442"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "OR",
            "license": "IP0001181CS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "034285",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2078292",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MANAGED HEALTHCARE OF OR LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Julie Bernice Lum, PT, DPT, OCS
• Shannon Cathleen Lutz, O.D.
• Aidan J Lynch
• Christine June Ma
• Mandy Mie Yu Mah
• Cristina Leigh Mandera, LMT
• Maple Street Clinic Pharmacy LLC (Maple Street Clinic Pharmacy)
• Maple Street Clinic, PC
• Noah Marek, PT
• Marilyn J Booth MD

• Long Term Care Pharmacy in Forest Grove, OR
• Providers in Forest Grove, OR by specialty
• Long Term Care Pharmacy in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.