NPIMap

Organization Active NPI

Community Pharmacy Redmond

  • Community/Retail Pharmacy
  • Redmond, OR
National Provider Identifier
1750787115
Registry record updated Nov 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
RP002979CS Issued in OR
Legal business name
COMMUNITY PHARMACY REDMOND
Practice address
1253 NW Canal Blvd
Redmond, OR 97756-1334
Phone
(541) 516-3807
Fax
(541) 516-3815
NPI assigned
Nov 13, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2014

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

Authorized official

Name
Jim Diegel
Title
Ceo
Phone
(541) 382-4321

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X RP002979CS OR Primary

Addresses

Primary practice location

1253 NW Canal Blvd
Redmond, OR 97756-1334

Mailing address

1253 NW Canal Blvd
Redmond, OR 97756-1334
Phone (541) 516-3807

Other identifiers 2

IdentifierTypeStateIssuer
2148646OtherPK
282848MedicaidOR

Other names 1

  • Community Pharmacy Redmond Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cascade Healthcare Community Inc19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1415836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415836800000",
    "number": "1750787115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1253 NW CANAL BLVD",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561334",
            "telephone_number": "541-516-3807",
            "fax_number": "541-516-3815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1253 NW CANAL BLVD",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561334",
            "telephone_number": "541-516-3807",
            "fax_number": "541-516-3815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY PHARMACY REDMOND",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-13",
        "last_updated": "2014-11-13",
        "status": "A",
        "authorized_official_last_name": "DIEGEL",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-382-4321"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OR",
            "license": "RP002979CS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2148646",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "282848",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Pharmacy Redmond",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Redmond, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2014; 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.