COMMUNITY COMPOUNDING PHARMACY (NPI# 1902068216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902068216 |
| Entity Type | Organization |
| Organization Name | COMMUNITY COMPOUNDING PHARMACY |
| Other Organization Name | COMMUNITY COMPOUNDING PHARMACY |
| Practice Address |
6025 Jean Rd Lake Oswego OR 97035-5307 |
| Practice Telephone | 5033037373 |
| Practice Fax Number | 5033444996 |
| Mailing Telephone | 5033037373 |
| Mailing Fax Number | 5033444996 |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2017-04-18 |
| Authorized Official Name | SUZANNE ROSENBERG (OWNER) |
| Authorized Official Telephone | 5033037373 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
RP0002481CS | OR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2079590 | 01 |
| Other Name | Type Code |
|---|---|
| COMMUNITY COMPOUNDING PHARMACY | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | COMMUNITY COMPOUNDING PHARMACY RX | 6025 Sw Jean Rd, Lake Oswego, OR 97035 |
| Oregon Corporations, Companies and Business Names | COMMUNITY COMPOUNDING PHARMACY, PC | 6025 Jean Rd, Lake Oswego, OR 97035 |
| Street Address |
6025 JEAN RD |
| City | LAKE OSWEGO |
| State | OR |
| Zip Code | 97035-5307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265039457 | Aaron Bohn | Pharmacist | 6025 Jean Rd, Lake Oswego, OR 97035-5307 | 2020-10-01 |
| 1285141580 | Duc Xuan Nguyen | Pharmacist | 6025 Jean Rd, Lake Oswego, OR 97035-5307 | 2018-01-08 |
| 1790209450 | Stephen Robert Kimbrough | Pharmacy Technician | 6025 Jean Rd, Lake Oswego, OR 97035-5307 | 2017-08-03 |
| 1295284420 | Carrie Barfield | Pharmacist | 6025 Jean Rd, Lake Oswego, OR 97035-5307 | 2016-09-29 |
| 1699197459 | Community Compounding Specialty Pharmacy, Inc. | Pharmacy | 6025 Jean Rd, Lake Oswego, OR 97035-5307 | 2014-01-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700127 | Teresa Siebenaler Scott | Social Worker | 3990 Sw Collins Way, Suite 202, Lake Owsego, OR 97035 | 2020-11-04 |
| 1528671567 | Martin Henry Lees | Internal Medicine | 14 Morningview Lane, Lake Oswego, OR 97035 | 2020-08-28 |
| 1356976187 | Premere Rehab LLC | Occupational Therapist | Infinity Rehab - The Springs At Lake Oswego, 3900 Kruse Way Pl, Lake Oswego, OR 97035 | 2020-03-12 |
| 1689212193 | Jennifer Chauvin | Nurse Practitioner | 20 Juarez Street, Lake Oswego, OR 97035 | 2019-12-16 |
| 1003396888 | Sarah Guenzburger | Physical Therapist | 3900 Kruse Way Pl, Lake Oswego, OR 97035 | 2018-08-21 |
| 1568964252 | Brett Johnson | Marriage & Family Therapist | 5655 Southwood Dr, Lake Oswego, OR 97035 | 2018-03-08 |
| 1912416561 | Michael Paul Long | Social Worker | 14523 Westlake Drive, Lake Oswego, Or 97035, Lake Oswego, OR 97035 | 2017-09-27 |
| 1467807859 | Misty Lohn | Nurse Practitioner | 5 Centerpointe Dr., Ste 600, Lake Oswego, OR 97035 | 2016-05-04 |
| 1326405473 | Kelsey Prince | Behavioral Analyst | 6400 Sw Rosewood St., Portland (lake Oswego), OR 97035 | 2016-01-20 |
| 1942683388 | Elizabeth Risberg Harrison | Massage Therapist | 190 Oswego Summit, Lake Oswego, OR 97035 | 2015-07-02 |
| Find all providers in zip 97035 | ||||
| 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 |
|---|---|---|---|---|
| 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 | ||||
| City | LAKE OSWEGO |
| Zip Code | 97035 |
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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.