NPIMap

Organization Active NPI

Legacy Mount Hood Medical Center

  • Community/Retail Pharmacy
  • Gresham, OR
National Provider Identifier
1992725477
Registry record updated Feb 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
IP-000221-CS Issued in OR
Legal business name
LEGACY MOUNT HOOD MEDICAL CENTER
Practice address
24800 SE Stark St
Gresham, OR 97030-3378
Phone
(503) 674-1230
NPI assigned
Jul 20, 2006
Organization subpart
Yes
Parent organization
LEGACY MOUNT HOOD MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 17, 2017

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

Authorized official

Name
Linda S Hoff
Title
Sr VP and Cfo
Phone
(503) 415-5730

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X IP-000221-CS OR Primary

Addresses

Primary practice location

24800 SE Stark St
Gresham, OR 97030-3378

Mailing address

PO Box 4037
Portland, OR 97208-4037
Phone (503) 413-3958

Other identifiers 1

IdentifierTypeStateIssuer
3808954OtherORNCPDP

Other names 1

  • Legacy Mount Hood Medical Center Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Legacy Mount Hood Med CNTR3 organizations share this tax ID, including this one
Part of
Legacy Mount Hood Med CNTR

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

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": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487289600000",
    "number": "1992725477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4037",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084037",
            "telephone_number": "503-413-3958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24800 SE STARK ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303378",
            "telephone_number": "503-674-1230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY MOUNT HOOD MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LEGACY MOUNT HOOD MEDICAL CENTER",
        "enumeration_date": "2006-07-20",
        "last_updated": "2017-02-17",
        "status": "A",
        "authorized_official_last_name": "HOFF",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "SR VP AND CFO",
        "authorized_official_telephone_number": "503-415-5730"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OR",
            "license": "IP-000221-CS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3808954",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Mount Hood Medical Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.