MR. CHARLES DERRIS HURLEY (NPI# 1558516716) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558516716 |
| Entity Type | Individual |
| Full Name | MR. CHARLES DERRIS HURLEY |
| Credential | R.PH. |
| Practice Address |
1540 Main St Safeway Pharmacy Sweet Home OR 97386-1614 |
| Mailing Address |
1540 Main St Safeway Pharmacy Sweet Home OR 97386 |
| Practice Telephone | 5413670675 |
| Practice Fax Number | 5413670678 |
| Mailing Telephone | 5413670675 |
| Mailing Fax Number | 5413670678 |
| Enumeration Date | 2008-12-01 |
| Last Update Date | 2016-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 8111 | OR | Pharmacy Service Providers |
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
08111 | OR | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255736278 | Charles Daniel Hurley | Dentist | 14377 Woodlake Dr, Ste 211, Chesterfield, MO 63017-5735 | 2014-11-03 |
| Street Address |
1540 MAIN ST SAFEWAY PHARMACY |
| City | SWEET HOME |
| State | OR |
| Zip Code | 97386-1614 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750310793 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 1540 Main St, Sweet Home, OR 97386-1614 | 2006-07-02 |
| 1972805257 | Chris Alan Rice | Pharmacist | 1540 Main St, Sweet Home, OR 97386-1614 | 2010-11-19 |
| 1205138666 | Ronnie Hill | Pharmacist | 1540 Main St, Sweet Home, OR 97386-1614 | 2010-11-17 |
| 1023319555 | Frands Thomas Lemar | Pharmacist | 1540 Main St, Sweet Home, OR 97386-1614 | 2010-11-15 |
| 1730419441 | Brandy Glynn Davis | Pharmacist | 1540 Main St, Sweet Home, OR 97386 | 2009-12-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649693342 | Bi-mart Corporation | Durable Medical Equipment & Medical Supplies | 1980 Main Street, Sweet Home, OR 97386 | 2014-01-31 |
| 1891705901 | Christopher Elliot Simmons | Social Worker | 799 Long St, Sweet Home, OR 97386 | 2006-08-09 |
| 1912324583 | Muhammad A Qudoos | Pharmacist | 679 Main St, Sweet Home, OR 97386 | 2014-03-21 |
| 1770640682 | Dennis M Lynch | Chiropractor | 920 Main St, Sweet Home, OR 97386 | 2007-01-02 |
| 1073954806 | Lifesource,inc | Community/Behavioral Health | 1266 44th Ave, Sweet Home, OR 97386-1235 | 2013-07-09 |
| 1124596879 | Peter Kauffman | Counselor | 1266 44th Ave, Sweet Home, OR 97386-1235 | 2018-11-10 |
| 1568659373 | Lynch Family Chiropractic Clinic PC | Chiropractor | 920 Main St, Sweet Home, OR 97386-1512 | 2007-09-26 |
| 1609919760 | Danca Lenna Inc | Pharmacy | 1023 Main St, Sweet Home, OR 97386-1515 | 2007-02-15 |
| 1053338004 | Twin Oaks Rehab, Inc. | Skilled Nursing Facility | 950 Nandina St, Sweet Home, OR 97386-1522 | 2006-07-16 |
| 1720346638 | Premere Rehab, LLC | Occupational Therapist | 950 Nandina St, Sweet Home, OR 97386-1522 | 2012-04-27 |
| Find all providers in zip 97386 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194385674 | Joseph Lee Combee | Pharmacist | 4956 Sw Aster St, Corvallis, OR 97333-1367 | 2019-06-17 |
| 1538627377 | Jacquelyn Jessica Lansing | Pharmacist | 33190 Bloomberg Rd, Eugene, OR 97405-9609 | 2019-03-12 |
| 1972097699 | Nathan Daniel Hoover | Pharmacist | 1401 North 10th Ave, Stayton, OR 97383 | 2018-06-16 |
| 1083119994 | Timothy Warren Evans | Pharmacist | 2714 Harbeck Rd, Grants Pass, OR 97527-5630 | 2018-03-24 |
| 1144737677 | Matthew Ito | Pharmacist | 5805 Sw Delker Rd, Tualatin, OR 97062-7753 | 2018-01-05 |
| 1588178701 | Daniel Hendrickson | Pharmacist | 503 Sw 5th Avenue, Portland, OR 97204 | 2017-11-27 |
| 1336662204 | Jenny French | Pharmacist | 9427 Sw Barnes Rd Ste 295, Portland, OR 97225-6652 | 2017-07-21 |
| 1104378199 | Derek Andrus | Pharmacist | 5717 Nw 138th, Portland, OR 97230 | 2016-10-26 |
| 1841747649 | Richard Bennett | Pharmacist | 425 Burlwood Ave N, Monmouth, OR 97361-2252 | 2016-09-09 |
| 1316390008 | Timothy L Lichlyter | Pharmacist | 2924 Siskiyou Blvd Ste 102, Medford, OR 97504-8194 | 2016-07-18 |
| Find all providers with the same taxonomy | ||||
| City | SWEET HOME |
| Zip Code | 97386 |
Please comment or provide details below to improve the information on MR. CHARLES DERRIS HURLEY.
| 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.