NPIMap

Organization Active NPI

Portland Adventist Medical Center

Doing business as Adventist Medical Center Pharmacy

  • Community/Retail Pharmacy
  • Portland, OR
National Provider Identifier
1790752533
Registry record updated Aug 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
RP-0000889-CS Issued in OR
Legal business name
PORTLAND ADVENTIST MEDICAL CENTER
Doing business as
Adventist Medical Center Pharmacy
Practice address
10123 SE Market St
Portland, OR 97216-2532
Phone
(503) 251-6141
Fax
(503) 261-6643
NPI assigned
Mar 1, 2006
Last updated
Aug 21, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
PORTLAND ADVENTIST MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 21, 2014

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

Authorized official

Name
Joyce L Newmyer
Title
Ceo
Phone
(503) 257-2500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X RP-0000889-CS OR Primary

Addresses

Primary practice location

10123 SE Market St
Portland, OR 97216-2532

Mailing address

PO Box 16800
Portland, OR 97292-0800
Phone (503) 251-6141

Other identifiers 2

IdentifierTypeStateIssuer
275183MedicaidOR
269070MedicaidOR

Other names 1

  • ADVENTIST MEDICAL CENTER PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sears Roebuck and Co2 organizations share this tax ID, including this one
Part of
Sears Roebuck and Co

Other organizations with this tax ID 1

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408579200000",
    "number": "1790752533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16800",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972920800",
            "telephone_number": "503-251-6141",
            "fax_number": "503-261-6643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10123 SE MARKET ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162532",
            "telephone_number": "503-251-6141",
            "fax_number": "503-261-6643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND ADVENTIST MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PORTLAND ADVENTIST MEDICAL CENTER",
        "enumeration_date": "2006-03-01",
        "last_updated": "2014-08-21",
        "status": "A",
        "authorized_official_last_name": "NEWMYER",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "503-257-2500"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OR",
            "license": "RP-0000889-CS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275183",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269070",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ADVENTIST MEDICAL CENTER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.