Active NPI
Loren Podoll
- Pharmacist
- Medford, OR
National Provider Identifier
1972916492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH-0013627
- Practice address
- 2000 Crater Lake Hwy
Medford, OR 97504-4161 - Phone
- (541) 779-5110
- NPI assigned
- Jun 3, 2014
- Sex
- Male
- Sole proprietor
- No
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 | RPH-0013627 | OR | Primary |
Addresses
Primary practice location
2000 Crater Lake Hwy
Medford, OR 97504-4161
Mailing address
1920 Madras St SE
Apt 2028
Salem, OR 97306-2082
Phone (701) 212-6805
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH-0013627 | OR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401753600000",
"number": "1972916492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1920 MADRAS ST SE",
"address_2": "APT 2028",
"city": "SALEM",
"state": "OR",
"postal_code": "973062082",
"telephone_number": "701-212-6805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 CRATER LAKE HWY",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975044161",
"telephone_number": "541-779-5110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PODOLL",
"first_name": "LOREN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-03",
"last_updated": "2014-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "RPH-0013627",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.