NPIMap

Organization Active NPI

Pharmacy Acquisition Co., LLC

  • Community/Retail Pharmacy
  • Portland, OR
National Provider Identifier
1922536606
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PHARMACY ACQUISITION CO., LLC
Doing business as
NewEra Pharmacy
Practice address
1286 SE Holgate Blvd # C-2
Portland, OR 97202-5053
Phone
(503) 222-4822
Fax
(503) 222-4868
NPI assigned
May 25, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Tyler Matthew Treharne, PHARMD.NPI 1407183833
Title
Owner
Phone
(503) 338-9840

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary
Compounding Pharmacy 3336C0004X RP-0000985-CS OR
Mail Order Pharmacy 3336M0002X
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

1286 SE Holgate Blvd # C-2
Portland, OR 97202-5053

Mailing address

1286 SE Holgate Blvd # C-2
Portland, OR 97202-5053
Phone (503) 222-4822

Other identifiers 1

IdentifierTypeStateIssuer
500733435MedicaidOR

Other names 1

  • NewEra Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

1286 SE Holgate Blvd
#C2
Portland, OR 97202
Phone (503) 222-4822

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1495670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1922536606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1286 SE HOLGATE BLVD # C-2",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972025053",
            "telephone_number": "503-222-4822",
            "fax_number": "503-222-4868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1286 SE HOLGATE BLVD # C-2",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972025053",
            "telephone_number": "503-222-4822",
            "fax_number": "503-222-4868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACY ACQUISITION CO., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-25",
        "last_updated": "2022-07-21",
        "certification_date": "2021-06-02",
        "status": "A",
        "authorized_official_last_name": "TREHARNE",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-338-9840",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "OR",
            "license": "RP-0000985-CS",
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500733435",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NewEra 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 Jul 21, 2022; 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.