LEGACY MERIDAN PARK HOSPITAL (NPI# 1497170849) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497170849 |
| Entity Type | Organization |
| Organization Name | LEGACY MERIDAN PARK HOSPITAL |
| Other Organization Name | MERIDIAN PARK MEDICAL CENTER COMMUNITY PHARMACY |
| Practice Address |
19300 Sw 65th Ave Tualatin OR 97062-7706 |
| Practice Telephone | 5036927470 |
| Practice Fax Number | 5036927437 |
| Mailing Telephone | 5036922454 |
| Mailing Fax Number | 5036927437 |
| Enumeration Date | 2014-02-21 |
| Last Update Date | 2015-03-09 |
| Authorized Official Name | MICHAEL SIEG (PHCY SRVCS MGR) |
| Authorized Official Telephone | 5036922665 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
RP-0000864 | OR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2144384 | 01 |
| Other Name | Type Code |
|---|---|
| Meridian Park Medical Center Community Pharmacy | Doing Business As Name - Organization |
| Street Address |
19300 SW 65TH AVE |
| City | TUALATIN |
| State | OR |
| Zip Code | 97062-7706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063417392 | Paul R Ash | Psychiatry & Neurology | 19300 Sw 65th Ave, Tualatin, OR 97062-7706 | 2005-06-14 |
| 1689217044 | Jacob White | Pharmacist | 19300 Sw 65th Ave, Tualatin, OR 97062-7706 | 2019-10-17 |
| 1679114011 | Jeri Leanne Shanahan | Pharmacist | 19300 Sw 65th Ave, Tualatin, OR 97062-7706 | 2019-10-07 |
| 1255840161 | Cinthia Marie Adair | Speech-Language Pathologist | 19300 Sw 65th Ave, Tualatin, OR 97062-7706 | 2017-09-22 |
| 1609311059 | Olivia Terris | Dietitian, Registered | 19300 Sw 65th Ave, Cardiac and Pulmonary Rehab, Tualatin, OR 97062-7706 | 2016-12-21 |
| 1568826386 | Kathryn Renee Foutch | Internal Medicine | 19300 Sw 65th Ave, Tualatin, OR 97062-7706 | 2016-04-07 |
| 1497129035 | Job Anderson | Pharmacist | 19300 Sw 65th Ave, Tualatin, OR 97062-7706 | 2015-11-19 |
| 1750775698 | Jessica Lorenz | Internal Medicine | 19300 Sw 65th Ave, Tualatin, OR 97062 | 2015-03-27 |
| 1528487956 | Raelin Fullmer I | Internal Medicine | 19300 Sw 65th Ave, Tualatin, OR 97062 | 2014-04-14 |
| 1992145775 | John Robert Turner | Emergency Medicine | 19300 Sw 65th Ave, Tualatin, OR 97062-9741 | 2013-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467018739 | Activeedge Tualatin, LLP | Physical Therapist | 19150 Sw 90th Avenue, Suite 200, West Linn, OR 97062 | 2019-05-13 |
| 1932607934 | Naturalways Pediatrics | Clinic/Center | 18813 Sw Martiazzi Ave, Tualatin, OR 97062 | 2018-01-25 |
| 1831646280 | Elizabeth Erin Tafesse | Behavioral Analyst | 18765 Sw Boones Ferry Rd Suite 100, Tualatin, OR 97062 | 2016-09-01 |
| 1962851311 | Ana Mercedes Cerritos-sanchez | Community Health Worker | 19355 Sw 65th Ave Apt A5, Tualatin, OR 97062 | 2016-06-07 |
| 1952759318 | William Luke Summers | Counselor | 18840 Southwest Boones Ferry Rd, Suite 208, Tualatin, OR 97062 | 2016-05-26 |
| 1730536913 | Krystle Alligood | Behavioral Analyst | 18768 Sw Boones Ferry Road, Tualatin, OR 97062 | 2016-05-18 |
| 1760869739 | Oregon City Medical Nw, Inc | Clinic/Center | 6464 Sw Borland Road #d-4, Tualatin, OR 97062 | 2015-04-29 |
| 1396148904 | Tracy Filley | Clinical Nurse Specialist | 18840 Sw Boones Ferry Rd, Suite 208, Tualatin, OR 97062 | 2014-09-28 |
| 1043646474 | Michelle Lords | Registered Nurse | 7668 Sw Mohawk Street, Tualatin, OR 97062 | 2013-09-17 |
| 1871930750 | Sharon Ruth Frank | Social Worker | 7668 Sw Mohawk St., Aps Healthcare, Tualatin, OR 97062 | 2013-05-31 |
| Find all providers in zip 97062 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| 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: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144523168 | P Bowman LLC | Pharmacy | 19297 Sw Martinazzi Ave, Tualatin, OR 97062-6352 | 2010-12-13 |
| 1689694150 | Legacy Meridian Park Hospital | Pharmacy | 19300 Sw 65th Ave, Tualatin, OR 97062-7706 | 2006-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972104354 | Jrrx LLC | Pharmacy | 621 Hickory St Nw, Albany, OR 97321-1754 | 2020-11-03 |
| 1346850641 | Credena Health LLC | Pharmacy | 1510 Division St Ste 110, Oregon City, OR 97045-1572 | 2020-08-03 |
| 1235747775 | Cordant Pharmacy Oregon, LLC | Pharmacy | 6135 Ne 80th Ave Ste A2, Portland, OR 97218-4033 | 2020-07-21 |
| 1578184909 | Capsule Portland LLC | Pharmacy | 416 Nw 12th Ave, Portland, OR 97209-2907 | 2020-04-27 |
| 1588291645 | Avita Drugs Oregon, LLC | Pharmacy | 2236 Se Belmont St Ste B, Portland, OR 97214-2817 | 2020-03-26 |
| 1467090183 | Mosaic Medical | Pharmacy | 375 Nw Beaver St Ste 103, Prineville, OR 97754-1802 | 2019-12-12 |
| 1598302119 | Beacon Health Care Solutions Incorporated | Pharmacy | 2790 Broadway Ave, North Bend, OR 97459-2216 | 2019-12-02 |
| 1508337577 | Oregon Health & Science University | Pharmacy | 3303 Sw Bond Ave Rm 1090, Portland, OR 97239-4501 | 2018-12-17 |
| 1588131296 | Home Town Drugs of Cottage Grove, Inc. | Pharmacy | 1205 Hwy 99 North, Cottage Grove, OR 97424 | 2018-10-31 |
| 1659857480 | Avalina Pharmacy Inc | Pharmacy | 3507 Commercial St Se, Salem, OR 97302 | 2018-07-16 |
| Find all providers with the same taxonomy | ||||
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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.