SISKIYOU COMMUNITY HEALTH CENTER, INC (NPI# 1831425164) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831425164 |
| Entity Type | Organization |
| Organization Name | SISKIYOU COMMUNITY HEALTH CENTER, INC |
| Other Organization Name | SISKIYOU COMMUNITY HEALTH CENTER PHARMACY |
| Practice Address |
1701 Nw Hawthorne Ave Grants Pass OR 97526-1257 |
| Practice Telephone | 5414724747 |
| Practice Fax Number | 5414724786 |
| Mailing Telephone | 5414713455 |
| Mailing Fax Number | 5414719242 |
| Enumeration Date | 2009-10-21 |
| Last Update Date | 2017-03-30 |
| Authorized Official Name | RICHARD BOOTH (COO) |
| Authorized Official Telephone | 5414713455 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
RP0002572CS | OR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 127725 | 05 | |
| OR | 500614374 | 05 | |
| PK | 2122472 | 01 |
| Other Name | Type Code |
|---|---|
| Siskiyou Community Health Center Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427046903 | Siskiyou Community Health Center, Inc | Clinic/Center | 1701 Nw Hawthorne Ave, Grants Pass, OR 97526-1257 | 2005-10-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | SISKIYOU COMMUNITY HEALTH CENTER, INC. | 1701 Nw Hawthorne Ave, Grants Pass, OR 97526 |
| Street Address |
1701 NW HAWTHORNE AVE |
| City | GRANTS PASS |
| State | OR |
| Zip Code | 97526-1257 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740272285 | Kristin Miller | Family Medicine | 1701 Nw Hawthorne Ave, Suite 201, Grants Pass, OR 97526-1257 | 2005-08-19 |
| 1245846922 | Allison Mae Swanson | Dentist | 1701 Nw Hawthorne Ave, Grants Pass, OR 97526-1051 | 2020-09-18 |
| 1649821216 | Jodi Michelle Bostwick | Nurse Practitioner | 1701 Nw Hawthorne Ave, Grants Pass, OR 97526-1051 | 2019-09-25 |
| 1063998730 | Donald Ray Draper | Dentist | 1701 Nw Hawthorne Ave, Grants Pass, OR 97526 | 2018-07-16 |
| 1427563337 | Andrew Martin | Nurse Practitioner | 1701 Nw Hawthorne Ave, Grants Pass, OR 97526-1051 | 2017-12-14 |
| 1528581550 | Lauren Smith | Dentist | 1701 Nw Hawthorne Ave, Grants Pass, OR 97526-1051 | 2017-07-21 |
| 1063958924 | Amy Tripp | Dental Hygienist | 1701 Nw Hawthorne Ave, Grants Pass, OR 97526-1257 | 2017-01-16 |
| 1619428208 | Christopher Robert Cielinski | Physician Assistant | 1701 Nw Hawthorne Ave, Grants Pass, OR 97526-1051 | 2016-10-18 |
| 1275081184 | Paloma Sita Kolkow | Nurse Practitioner | 1701 Nw Hawthorne Ave, Grants Pass, OR 97526-1257 | 2016-09-20 |
| 1780034629 | Devin Nelson | Dentist | 1701 Nw Hawthorne Ave, Grants Pass, OR 97526-1257 | 2016-06-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205476777 | Kyla M Mccormick | Peer Specialist | 109 Nw Manzanita Avenue, Grants Pass, OR 97526 | 2020-01-13 |
| 1164076469 | Alicia Yvonne Hansen | Counselor | 1055 Clarey St., Grants Pass, OR 97526 | 2019-07-25 |
| 1841842598 | Michael Liam Reynolds, Dds, LLC | Dentist | 984 Ne 8th Street, Grants Pass Oregon, Grants Pass, OR 97526 | 2019-07-12 |
| 1881254746 | Brandi Mccrorey | Counselor | 418 Ne 6th Street, Suite 102, Grants Pass, OR 97526 | 2019-06-13 |
| 1700364502 | Premier Community Supports, LLC. | Day Training, Developmentally Disabled Services | 1439 Ne 6th St Ste C, Grants Pass, OR 97526 | 2018-08-02 |
| 1821584509 | Stefani Mcintyre | Massage Therapist | 1590 Se N Street, Warehouse #1574, Grants Pass, OR 97526 | 2018-07-06 |
| 1114467438 | Sandra P Martin | Chiropractor | 333 Sw 5th St. Suite B, Grants Pass, OR 97526 | 2017-03-06 |
| 1801347612 | Maci Wageman | Counselor | 1215 Sw G St Grants Pass Oregon 97526, Grants Pass, OR 97526 | 2016-10-17 |
| 1902353907 | Optimal Health of Southern Oregon, LLC | Family Medicine | 1600 Nw 6th St South Suite, Grants Pass, OR 97526 | 2016-09-07 |
| 1982150793 | Tanya White | Counselor | 402 Nw Fstreet, Grants Pass, OR 97526 | 2016-08-31 |
| Find all providers in zip 97526 | ||||
| Taxonomy Code | 3336C0002X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Clinic Pharmacy |
| A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |
| 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 |
|---|---|---|---|---|
| 1427346543 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 5381 E Main St, Hillsboro, OR 97123-6447 | 2011-07-11 |
| 1922141415 | Oregon Health and Science University | Pharmacy | 515 Sw Campus Drive, Portland, OR 97239-3098 | 2007-02-14 |
| 1225190408 | Credena Health LLC | Pharmacy | 9155 Sw Barnes Rd Ste 102, Portland, OR 97225-6625 | 2006-12-14 |
| 1578630463 | Good Shepherd Health Care Systems | Pharmacy | 600 Nw 11th St Ste E04, Hermiston, OR 97838-8602 | 2006-11-29 |
| 1275548059 | Multnomah County Oregon | Pharmacy | 600 Ne 8th St Fl 3, Gresham, OR 97030-7317 | 2006-07-30 |
| 1528073327 | Multnomah County Oregon | Pharmacy | 619 Nw 6th Ave Fl 1, Portland, OR 97209-3964 | 2006-07-30 |
| 1205841004 | Multnomah County | Pharmacy | 9000 N Lombard St Fl 2, Portland, OR 97203-3006 | 2006-07-30 |
| 1528073319 | Multnomah County | Pharmacy | 5329 Ne Martin L King Fl Jrblvd2, Portland, OR 97211-3237 | 2006-07-30 |
| 1346263340 | Oregon Health & Science University | Pharmacy | 3270 Sw Pavilion Loop, Suite Ppv 110, Portland, OR 97239-3011 | 2006-07-25 |
| 1063040186 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 360 S Garden Way Ste 120, Eugene, OR 97401-8173 | 2020-04-01 |
| Find all providers with the same taxonomy | ||||
| City | GRANTS PASS |
| Zip Code | 97526 |
Please comment or provide details below to improve the information on SISKIYOU COMMUNITY HEALTH CENTER, INC.
| 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.