PROCARE PHARMACY LLC (NPI# 1366436057) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366436057 |
| Entity Type | Organization |
| Organization Name | PROCARE PHARMACY LLC |
| Other Organization Name | CVS PHARMACY #11280 |
| Practice Address |
538 Sw 4th Ave Portland OR 97204-2102 |
| Mailing Address |
1 Cvs Drive Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 5032270468 |
| Practice Fax Number | 5032232439 |
| Mailing Telephone | 4017651500 |
| Mailing Fax Number | 5032232439 |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2018-01-24 |
| Authorized Official Name | SUSAN COLBERT (SR DIRECTOR PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | 444 | OR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | NABP OR NCPDP | 3803435 | 01 |
| OR | 024513 | 05 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #11280 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669549580 | Procare Pharmacy LLC | Clinical Medical Laboratory | 6 Pinetree Dr, Ste 290 Northpark Center, Arden Hills, MN 55112 | 2006-11-29 |
| 1013089382 | Procare Pharmacy LLC | Pharmacy | 1001 Madison St, Seattle, WA 98104-1263 | 2006-11-14 |
| 1205930104 | Procare Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2101 N Ursula St Unit 35, Aurora, CO 80045-7426 | 2006-09-12 |
| 1003925587 | Procare Pharmacy LLC | Pharmacy | 126 8th Ave, New York, NY 10011-5108 | 2006-08-29 |
| 1760591234 | Procare Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 35 Kneeland St, Boston, MA 02111-1523 | 2006-08-29 |
| 1962511436 | Procare Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1010 University Ave, San Diego, CA 92103-3398 | 2006-08-29 |
| 1720197205 | Procare Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2 Dudley St Ste 170, Providence, RI 02905-3246 | 2006-08-29 |
| 1407965973 | Procare Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 8607 Santa Monica Blvd, West Hollywood, CA 90069-4109 | 2006-08-29 |
| 1215046784 | Procare Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 560 Amsterdam Ave Ste E, Atlanta, GA 30306-3479 | 2006-08-29 |
| 1396785861 | Procare Pharmacy LLC | Pharmacy | 11 S Eutaw St, Baltimore, MD 21201 | 2006-06-06 |
| Street Address |
538 SW 4TH AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97204-2102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518259043 | Gary Duane Lundgren | Pharmacist | 538 Sw 4th Ave, Portland, OR 97204-2102 | 2011-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922662352 | Sleep Management, L.L.C. | Respiratory Therapist, Registered | 1050 Sw 6th Avenue, Suite 1100 Office # 52, Portland, OR 97204 | 2019-05-01 |
| 1588178701 | Daniel Hendrickson | Pharmacist | 503 Sw 5th Avenue, Portland, OR 97204 | 2017-11-27 |
| 1790133031 | Modupe Desiree Bansile | Counselor | 209 Sw Fourth Ave, Suite 520, Portland, OR 97204 | 2016-05-26 |
| 1841655834 | Isabella Zaragoza | Counselor | 421 Sw Oak St Suite 520, Portland, OR 97204 | 2015-12-18 |
| 1952737736 | Hessler-cohen Enterprises LLC | Acupuncturist | 310 Sw 4rth Avenue, Suite 725, Portland, OR 97204 | 2013-09-24 |
| 1144583378 | Angela Nicole Johnson | Physical Therapist | 555 Sw Oak Street, Portland, OR 97204 | 2012-06-22 |
| 1255614624 | Jaclyn Rene Jones | Nurse Practitioner | 601 Sw 4th Ave, Portland, OR 97204 | 2011-09-22 |
| 1407148398 | Cristianne Paulsen | Dental Hygienist | 426 Sw Stark, 9th Floor, Portland, OR 97204 | 2011-05-10 |
| 1396928255 | Jessica L Hall | Counselor | 421 Sw Oak Street, Suite 520, Portland, OR 97204 | 2007-12-13 |
| 1699896274 | Julie Anne Oyemaja | Counselor | 421 Sw Oak St., Ste. 210, Portland, OR 97204 | 2007-04-02 |
| Find all providers in zip 97204 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447725502 | Medsavvy, Inc | Pharmacy | 1621 Sw First Ave, Portland, OR 97201-5713 | 2018-10-04 |
| 1790294965 | Oregon Health & Science University | Pharmacy | 707 Sw Gaines St Rm 1133, Portland, OR 97239-2901 | 2017-09-20 |
| 1144767427 | Prestige Professional Pharmacy | Pharmacy | 11723 Ne Glisan St, Portland, OR 97220-2141 | 2017-01-25 |
| 1700321825 | Legacy Emanuel Hospital and Health Center | Pharmacy | Unity Center for Behavioral Health, 1225 Ne 2nd St, Portland, OR 97232 | 2016-12-28 |
| 1972908077 | Zoom Care PC | Pharmacy | 1455 Nw Irving St Ste 500, Portland, OR 97209-2277 | 2014-10-31 |
| 1275946428 | Rite Aid | Pharmacy | 11190 Sw Barnes Dr, Portland, OR 97225 | 2014-06-05 |
| 1033482385 | Strategic Pharmaceutical Solutions Inc | Pharmacy | 17014 Ne Sandy Blvd, Portland, OR 97230-5074 | 2012-02-17 |
| 1811212798 | Luke-dorf, Inc. | Pharmacy | 11349 Ne Sandy Blvd., Portland, OR 97220-1461 | 2010-04-02 |
| 1417100447 | Procare Pharmacy, L.L.C. | Pharmacy | 141 Preble St, Portland, ME 04101-2440 | 2008-11-04 |
| 1811140841 | Coastal Pharmacy LLC | Pharmacy | 29 Marginal Way, Suite 4, Portland, ME 04101-1914 | 2008-11-04 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.