Community Compounding Pharmacy

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

RP0002481CS Issued in OR

Legal business name

COMMUNITY COMPOUNDING PHARMACY

Doing business as

COMMUNITY COMPOUNDING PHARMACY

Practice address

6025 Jean Rd
Lake Oswego, OR 97035-5307

Phone

(503) 303-7373

Fax

(503) 344-4996

NPI assigned

Jun 27, 2008

Organization subpart

No

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

Authorized official

Name

Suzanne Rosenberg, RPH

Title

Owner

Phone

(503) 303-7373

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• COMMUNITY COMPOUNDING PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492473600000",
    "number": "1902068216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6025 JEAN RD",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970355307",
            "telephone_number": "503-303-7373",
            "fax_number": "503-344-4996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6025 JEAN RD",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970355307",
            "telephone_number": "503-303-7373",
            "fax_number": "503-344-4996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY COMPOUNDING PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-27",
        "last_updated": "2017-04-18",
        "status": "A",
        "authorized_official_last_name": "ROSENBERG",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-303-7373",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "OR",
            "license": "RP0002481CS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2079590",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COMMUNITY COMPOUNDING PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Compounding Pharmacy in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Compounding Pharmacy in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; 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.