Active NPI
Linda Marie Acidera, RPH
- Pharmacist
- Corvallis, OR
National Provider Identifier
1902170723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5720
- Practice address
- 777 NW Kings Blvd
Corvallis, OR 97330-5620 - Phone
- (541) 754-5583
- Fax
- (541) 754-5577
- NPI assigned
- Feb 24, 2012
- Last updated
- Feb 24, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5720 | OR | Primary |
Addresses
Primary practice location
777 NW Kings Blvd
Corvallis, OR 97330-5620
Mailing address
777 NW Kings Blvd
Corvallis, OR 97330-5620
Phone (541) 754-5583
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5720 | OR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fred Meyer Stores Inc | Past | Accepting new patients | |
| Fred Meyer Stores Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Fred Meyer Pharmacy
- Community/Retail Pharmacy
- Corvallis, OR
- NPI 1285679357
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1330041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330041600000",
"number": "1902170723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "777 NW KINGS BLVD",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973305620",
"telephone_number": "541-754-5583",
"fax_number": "541-754-5577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 NW KINGS BLVD",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973305620",
"telephone_number": "541-754-5583",
"fax_number": "541-754-5577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACIDERA",
"first_name": "LINDA",
"middle_name": "MARIE",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-02-24",
"last_updated": "2012-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "5720",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corvallis, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.