HOME TOWN DRUGS OF PRINEVILLE INC (NPI# 1801924006) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801924006 |
| Entity Type | Organization |
| Organization Name | HOME TOWN DRUGS OF PRINEVILLE INC |
| Other Organization Name | CLINIC PHARMACY |
| Practice Address |
1103 Ne Elm St Ste A Prineville OR 97754-1664 |
| Practice Telephone | 5414474111 |
| Practice Fax Number | 5414474111 |
| Mailing Telephone | 5414474111 |
| Mailing Fax Number | 5414474111 |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2011-11-23 |
| Authorized Official Name | MICHAEL MENDAZONA (DIRECTOR) |
| Authorized Official Telephone | 5413251059 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
00430 | OR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 3804273 | 01 | |
| OR | 228749 | 05 |
| Other Name | Type Code |
|---|---|
| Clinic Pharmacy | Doing Business As Name - Organization |
| Street Address |
1103 NE ELM ST STE A |
| City | PRINEVILLE |
| State | OR |
| Zip Code | 97754-1664 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841803186 | Elizabeth Bartelli-herman | Counselor | 1103 Ne Elm St, Prineville, OR 97754-1664 | 2020-08-26 |
| 1689286700 | Robert Dawson | Case Manager/Care Coordinator | 1103 Ne Elm St, Prineville, OR 97754-1664 | 2020-08-19 |
| 1992317135 | Rob Mcqueen-jensen | Case Manager/Care Coordinator | 1103 Ne Elm St, Prineville, OR 97754-1664 | 2020-08-19 |
| 1568089423 | Mandee Ray Awmiller | Counselor | 1103 Ne Elm St, Prineville, OR 97754-1664 | 2020-06-26 |
| 1538784053 | Leah Nieradka | Counselor | 1103 Ne Elm St, Prineville, OR 97754-1664 | 2020-06-10 |
| 1659907483 | Grant Hill | Counselor | 1103 Ne Elm St, Prineville, OR 97754-1664 | 2020-03-12 |
| 1376176834 | Natalie Lantz | Counselor | 1103 Ne Elm St, Prineville, OR 97754-1664 | 2020-02-12 |
| 1245870963 | Donna Buring | Counselor | 1103 Ne Elm St, Prineville, OR 97754-1664 | 2020-01-10 |
| 1437799194 | Hugh Thomas Shepard | Counselor | 1103 Ne Elm St, Prineville, OR 97754-1664 | 2020-01-10 |
| 1497398317 | Amanda Lynn Sandoval | Social Worker | 1103 Ne Elm St, Prineville, OR 97754-1664 | 2019-10-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598246290 | Phyllis Louise Young | Physical Therapy Assistant | 350 Ne Brennan Ln, Prineville, OR 97754 | 2018-08-22 |
| 1316424518 | Monte Bainbridge | Counselor | 1103 Ne Elm St Ste B, Prineville, OR 97754 | 2018-07-20 |
| 1841739760 | Gregory Wayne Sanders | Marriage & Family Therapist | 445 Nw 3rd Street, Prineville, OR 97754 | 2017-02-13 |
| 1114474962 | Amy R Duryea | Counselor | 1103 Ne Elm St., Prineville, OR 97754 | 2016-09-08 |
| 1669855052 | Rebecca L Griffith | Mechanotherapist | 298 N Holly St, Prineville, OR 97754 | 2015-07-02 |
| 1376810838 | Jessica Lynn Neely | Counselor | 1333 Nw 9th Street, Prineville, OR 97754 | 2011-11-28 |
| 1205076130 | Dean Arthur Laney | Registered Nurse | 375 Nw Beaver St., Suite 100, Prineville, OR 97754 | 2009-03-05 |
| 1699910513 | Ross E Weakley | Acupuncturist | 298 Sw Harwood, Prineville, OR 97754 | 2008-12-05 |
| 1326208752 | Laura Danielle Gratton | Family Medicine | 975 Nw Beaver Street, Prineville, OR 97754 | 2008-06-10 |
| 1811174550 | Central Oregon Eyecare, PC | Optometrist | 198 Ne Combs Flat Rd, Ste 120, Prineville, OR 97754 | 2008-01-24 |
| Find all providers in zip 97754 | ||||
| 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 |
|---|---|---|---|---|
| 1467090183 | Mosaic Medical | Pharmacy | 375 Nw Beaver St Ste 103, Prineville, OR 97754-1802 | 2019-12-12 |
| 1629118229 | Christiansen, LLC | Pharmacy | 136 Ne 3rd St, Prineville, OR 97754-1915 | 2007-02-06 |
| 1346492683 | Hans Pharmacy Inc | Pharmacy | 136 Ne 3rd St, Prineville, OR 97754-1915 | 2008-10-17 |
| 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 |
| 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 |
| 1578049631 | Credena Health LLC | Pharmacy | 4805 Ne Glisan St Ste 11n321, Portland, OR 97213 | 2018-07-12 |
| Find all providers with the same taxonomy | ||||
| City | PRINEVILLE |
| Zip Code | 97754 |
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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.