Outdoor World Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

RP-0000217 Issued in OR

Legal business name

OUTDOOR WORLD INC

Practice address

1204 NW 6TH St
Grants Pass, OR 97526-1254

Phone

(541) 476-8224

Fax

(541) 476-4132

NPI assigned

Oct 20, 2006

Organization subpart

No

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

Authorized official

Name

Debbie Cantiello, BS

Title

Business Manager

Phone

(541) 476-8224

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• SERVICE DRUG STORE Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tyler Paul Flaming, RPH

  • Pharmacist
  • Grants Pass, OR
  • NPI 1679846216
  NPD (past)
• William Frank Flaming, RPH

  • Pharmacist
  • Grants Pass, OR
  • NPI 1487927042
  NPD (past)
• Andrew James Scott, RPH

  • Pharmacist
  • Grants Pass, OR
  • NPI 1912270570
  NPD (past)

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377475200000",
    "number": "1851473656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 NW 6TH ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261254",
            "telephone_number": "541-476-8224",
            "fax_number": "541-476-4132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 NW 6TH ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261254",
            "telephone_number": "541-476-8224",
            "fax_number": "541-476-4132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTDOOR WORLD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2013-08-26",
        "status": "A",
        "authorized_official_last_name": "CANTIELLO",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "541-476-8224",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OR",
            "license": "RP-0000217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190751",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2077236",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SERVICE DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Oregon Heights, LLC
• Laura S Orndoff, RPH
• Carol Orton
• Andrea Grace Otsuki, QMHA
• Laurie M Otte, NP
• Gregory Robert Owens, MD
• Kiaya Lynn Pace
• Pacific Living Centers South, LLC
• Lauren Packard, PA-C
• Fiasau Paese

• Community/Retail Pharmacy in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Community/Retail Pharmacy in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.