NPIMap

Organization Active NPI

Peace Health Pharmacy

  • Clinic Pharmacy
  • Eugene, OR
National Provider Identifier
1811908668
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
001133 Issued in OR
Legal business name
PEACE HEALTH PHARMACY
Practice address
1200 Hilyard St
Ste S-110
Eugene, OR 97439-8112
Phone
(541) 349-7630
Fax
(541) 349-7630
NPI assigned
Aug 10, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
David Leger-Jeffrey, RPH
Title
Pharmicist in Charge
Phone
(541) 349-7630

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X 001133 OR Primary

Addresses

Primary practice location

1200 Hilyard St
Ste S-110
Eugene, OR 97439-8112

Mailing address

1200 Hilyard St
Ste S-110
Eugene, OR 97439-8112
Phone (541) 349-7630

Other identifiers 2

IdentifierTypeStateIssuer
170419MedicaidOR
001133OtherORSTATE LIC #

Other names 1

  • Peace Health Pharmacy Hilyard Other name

National Provider Directory

National Provider Directory
Tax ID family
Jay Park11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1811908668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 HILYARD ST",
            "address_2": "STE S-110",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974398112",
            "telephone_number": "541-349-7630",
            "fax_number": "541-349-7632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 HILYARD ST",
            "address_2": "STE S-110",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974398112",
            "telephone_number": "541-349-7630",
            "fax_number": "541-349-7630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE HEALTH PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "LEGER-JEFFREY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PHARMICIST IN CHARGE",
        "authorized_official_telephone_number": "541-349-7630",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "OR",
            "license": "001133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170419",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC #",
            "identifier": "001133",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peace Health Pharmacy Hilyard",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.