West Main Pharmacy

Primary specialty

PharmacyTaxonomy code 333600000X

License

291CS Issued in OR

Legal business name

WEST MAIN PHARMACY

Practice address

2355 W Main St
Medford, OR 97501-2161

Phone

(541) 772-2330

Fax

(541) 772-4852

NPI assigned

Nov 18, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Dennis Ray Clark, RPH

Title

President

Phone

(541) 944-1671

Specialties & licenses 1

Addresses

Other names 1

• west main drug Former legal business name

Locations

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

{
    "created_epoch": "1447804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447804800000",
    "number": "1942674676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 W MAIN ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975012161",
            "telephone_number": "541-772-2330",
            "fax_number": "541-772-4852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 W MAIN ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975012161",
            "telephone_number": "541-772-2330",
            "fax_number": "541-772-4852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST MAIN PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-18",
        "last_updated": "2015-11-18",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-944-1671",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "OR",
            "license": "291CS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "west main drug",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Pharmacy in Medford, OR
• Providers in Medford, OR by specialty
• Pharmacy in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; 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.