WILLAMETTE COMPOUNDING PHARMACY (NPI# 1750554622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750554622 |
| Entity Type | Organization |
| Organization Name | WILLAMETTE COMPOUNDING PHARMACY |
| Practice Address |
150 Liberty St Se Salem OR 97301-3506 |
| Practice Telephone | 5043643336 |
| Mailing Telephone | 5043643336 |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2008-04-10 |
| Authorized Official Name | MR. STEPHEN DWIGHT QUISENBERRY (PRESIDENT) |
| Authorized Official Telephone | 5033643336 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
2122 | OR | Suppliers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | WILLAMETTE COMPOUNDING PHARMACY, LLC | 1705 Fir St S, Salem, OR 97302 |
| Street Address |
150 LIBERTY ST SE |
| City | SALEM |
| State | OR |
| Zip Code | 97301-3506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881776722 | Quisenberry Pharmacies Inc. | Pharmacy | 150 Liberty St Se, Salem, OR 97301-3506 | 2006-10-19 |
| 1346787629 | Quisenberry Pharmacies | Pharmacy | 150 Liberty St Se, Salem, OR 97301-3506 | 2017-01-25 |
| 1659640449 | Caitlin Adele Fewx | Pharmacist | 150 Liberty St Se, Salem, OR 97301-3506 | 2011-12-22 |
| 1720237324 | Stephen Dwight Quisenberry | Pharmacist | 150 Liberty St Se, Salem, OR 97301-3506 | 2008-09-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205450970 | Jehan Seals | Behavior Technician | 3400 State St Set G750, Salem, OR 97301 | 2020-05-29 |
| 1093335929 | Sterling Recovery, LLC | Dietitian, Registered | 3758 Amber St Ne #105, Salem, OR 97301 | 2020-04-21 |
| 1760018360 | Riverfront Mental Health LLC | Counselor | 338 State St, Suite 985, Salem, OR 97301 | 2020-03-16 |
| 1871126888 | Amity Beth Haddon Maxwell | Social Worker | Oregon State Hospital, 2600 Center St Ne, Salem, OR 97301 | 2020-02-18 |
| 1861042632 | Brenda Grizelda Vargas | Behavioral Analyst | 3400 State Ste Ste G750, Salem, OR 97301 | 2019-09-13 |
| 1588213177 | Natalie Stone | Registered Nurse | 2045 Siverton Rd Ne, Salem, OR 97301 | 2019-09-06 |
| 1588228720 | Jeramy Disenso | Counselor | 270 Cottage St Ne, Salem, OR 97301 | 2019-04-23 |
| 1801353297 | Gwendolyn Kersey | Registered Nurse | 2600 Center St Ne Oregon State Hospital, Salem, OR 97301 | 2019-02-21 |
| 1841769114 | Spine Clinic PC | Massage Therapist | 1281 Lancaster Drive Ne, Salem, OR 97301 | 2018-11-16 |
| 1013482132 | Kellie Linn Hansen | Physical Therapist | 4049 Market St Se, Salem, OR 97301 | 2018-10-04 |
| Find all providers in zip 97301 | ||||
| Taxonomy Code | 3336C0004X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Compounding Pharmacy |
| A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner’s Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice. |
| Notes: Sources: NABP Model Practice Act, Appendix C - Good Compounding Practice, USP <795> and <797>, and Pharmacy Compounding Accreditation Board [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063756393 | South Salem Apothecary LLC | Pharmacy | 990 Commercial St Se, Salem, OR 97302-4110 | 2012-11-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528545969 | Willamette Pharmacy | Pharmacy | 10209 Se Division Build B Ste 100, Portland, OR 97266 | 2018-07-27 |
| 1922536606 | Pharmacy Acquisition Co., LLC | Pharmacy | 1286 Se Holgate Blvd # C-2, Portland, OR 97202-5053 | 2017-05-25 |
| 1023483823 | Central Oregon Pharmacy and Compounding | Pharmacy | 655 Nw Greenwood Ave Ste 1, Redmond, OR 97756-1672 | 2015-12-04 |
| 1124423793 | Cascade Compounding Center LLC | Pharmacy | 19550 Amber Meadow Dr, Suite 170, Bend, OR 97702-3525 | 2014-10-25 |
| 1841606662 | Redmond Long Term Care Pharmacy LLC | Pharmacy | 424 Nw 5th St Ste A, Redmond, OR 97756-1627 | 2014-07-02 |
| 1114274289 | Precision Compounds, LLC | Pharmacy | 9363 Sw Beaverton Hillsdale Hwy, Beaverton, OR 97005-3360 | 2012-08-08 |
| 1922284751 | Oregon Compounding Centers, Inc. | Pharmacy | 8560 Sw Salish Ln Ste 100, Wilsonville, OR 97070-9625 | 2008-01-10 |
| 1689873242 | New Seasons Market - Happy Valley | Pharmacy | 15861 Se Happy Valley Town Center Dr., Happy Valley, OR 97086 | 2007-07-13 |
| 1356555460 | Highland Park Pharmacy LLC | Pharmacy | 424 Nw 5th St, Redmond, OR 97756 | 2007-05-09 |
| 1578785119 | Pacific Compounds Pharmacy LLC | Pharmacy | 327 Se 3rd Ave, Hillsboro, OR 97123-4001 | 2007-05-03 |
| 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.