PEACEHEALTH MEDICAL GROUP (NPI# 1922018639) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922018639 |
| Entity Type | Organization |
| Organization Name | PEACEHEALTH MEDICAL GROUP |
| Other Organization Name | PEACEHEALTH EMPLOYEE PHARMACY |
| Practice Address |
3333 Riverbend Dr Springfield OR 97477-8800 |
| Practice Telephone | 5412225800 |
| Practice Fax Number | 5414319149 |
| Mailing Telephone | 5412225800 |
| Mailing Fax Number | 5414319149 |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2017-04-12 |
| Authorized Official Name | VESTALEE SHRADER (PHARMACY MANAGER - PIC) |
| Authorized Official Telephone | 5412225816 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
PHNR.FO.60259219 | WA | Suppliers |
| N | 333600000X | Pharmacy | RP-0000785-CS | OR | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHAO1124 | AK | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 053967 | 05 | |
| PK | 2077299 | 01 |
| Other Name | Type Code |
|---|---|
| PEACEHEALTH EMPLOYEE PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912013590 | Peacehealth Medical Group | Durable Medical Equipment & Medical Supplies | 430 W 7th Ave, Junction City, OR 97448-1619 | 2006-08-23 |
| 1386751758 | Peacehealth Medical Group | Durable Medical Equipment & Medical Supplies | 1200 Hilyard St Ste 200, Eugene, OR 97401-8146 | 2006-08-23 |
| 1508328840 | Peacehealth Medical Group | Durable Medical Equipment & Medical Supplies | 2484 River Rd, Eugene, OR 97404-2042 | 2019-04-04 |
| 1356806202 | Peacehealth Medical Group | Durable Medical Equipment & Medical Supplies | 2846 Willamette St, Eugene, OR 97405-8200 | 2019-02-05 |
| 1134658479 | Peacehealth Medical Group | Durable Medical Equipment & Medical Supplies | 1400 Valley River Dr Ste 110, Eugene, OR 97401-6758 | 2017-06-09 |
| 1821488891 | Peacehealth Medical Group | Durable Medical Equipment & Medical Supplies | 860 Beltline Rd, Springfield, OR 97477-1091 | 2015-01-29 |
| 1447554746 | Peacehealth Medical Group | Durable Medical Equipment & Medical Supplies | 3321 W 11th Ave, Eugene, OR 97402-3040 | 2010-12-29 |
| 1528218005 | Peacehealth Medical Group | Durable Medical Equipment & Medical Supplies | 3377 Riverbend Dr, Springfield, OR 97477 | 2008-09-22 |
| 1881860856 | Peacehealth Medical Group | Clinic/Center | 353 Deadmond Ferry Rd, Springfield, OR 97477-9406 | 2008-04-30 |
| 1386814333 | Peacehealth Medical Group | Eyewear Supplier (Equipment, not the service) | 1162 Willamette St, Eugene, OR 97401-3568 | 2008-03-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | PEACEHEALTH MEDICAL GROUP | 1200 Hilyard St, Eugene, OR 97401 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH MEDICAL GROUP - COTTAGE GROVE | 1515 Village Dr, Cottage Grove, OR 97424 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH MEDICAL GROUP - CRESWELL | 98 W Oregon Ave, Creswell, OR 97426 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH MEDICAL GROUP - DEXTER | 38843 Dexter Rd, Dexter, OR 97431 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH MEDICAL GROUP - SOUTH | 3299 Hilyard St, Eugene, OR 97405 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH MEDICAL GROUP-SIUSLAW | 380 Ninth St, Florence, OR 97439 |
| Street Address |
3333 RIVERBEND DR |
| City | SPRINGFIELD |
| State | OR |
| Zip Code | 97477-8800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275508574 | Charles Milton Cook | Anesthesiology | 3333 Riverbend Dr, Springfield, OR 97477-8800 | 2006-02-21 |
| 1790300945 | Lexi Mancuso | Pharmacist | 3333 Riverbend Dr, Springfield, OR 97477-8800 | 2020-06-13 |
| 1629690268 | Tiffany Diane Boehland | Pharmacist | 3333 Riverbend Dr, Springfield, OR 97477-8800 | 2020-05-16 |
| 1629600275 | Gregory Ripley | Pharmacist | 3333 Riverbend Dr, Springfield, OR 97477-8800 | 2020-02-11 |
| 1609336718 | Steven Barton | Pharmacist | 3333 Riverbend Dr, Springfield, OR 97477-8800 | 2019-03-23 |
| 1962985408 | Glacel Anne A Salagan | Nurse Practitioner | 3333 Riverbend Dr, Springfield, OR 97477-8800 | 2018-09-11 |
| 1538657838 | Erin Leigh Millard | Registered Nurse | 3333 Riverbend Dr, Springfield, OR 97477-8800 | 2018-04-23 |
| 1841703576 | Kaitlin Glaeser | Nurse Practitioner | 3333 Riverbend Dr, Springfield, OR 97477-8800 | 2017-11-16 |
| 1316477003 | Sean Egglestone | Dietitian, Registered | 3333 Riverbend Dr, Springfield, OR 97477-8800 | 2017-06-14 |
| 1023549466 | Kevin Matthew Allan | Emergency Medicine | 3333 Riverbend Dr, Springfield, OR 97477-8800 | 2017-03-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508416140 | Chase Michael Collings | Physician Assistant | 960 N 16th St Ste 303, Springfield, OR 97477 | 2019-09-16 |
| 1174079396 | Amie Flanagan | Occupational Therapy Assistant | 3152 Valentine Court, Springfield, OR 97477 | 2016-08-28 |
| 1609229590 | Kiernan Davis Snedigar | Counselor | 175 W B St Ste J, Springfield, OR 97477 | 2016-07-15 |
| 1578914206 | Ryan James Dixon | Counselor | 1923 Centennial Blvd, Springfield, OR 97477 | 2016-06-23 |
| 1902275464 | Jovonnie Bashaw | Counselor | 1157 5th St, Springfield, OR 97477 | 2015-09-15 |
| 1053759506 | Norco Inc | Durable Medical Equipment & Medical Supplies | 302 Shelley St Ste 7&8, Springfield, OR 97477 | 2013-06-06 |
| 1780931634 | Justin Morris | Pharmacist | 1891 Pioneer Parkway East, Springfield, OR 97477 | 2012-08-09 |
| 1194083105 | Mersedeh Bahr Hosseini | Psychiatry & Neurology | 3311 Riverbend Dr., Neurohospitalists, Springfield, OR 97477 | 2012-04-26 |
| 1962769679 | Hiro Kawata | Internal Medicine | 3311 Rierbend Dr., Springfield, OR 97477 | 2012-04-19 |
| 1659662823 | Wendy A Teigen | Counselor | 3995 Marcola Rd., Springfield, OR 97477 | 2011-04-22 |
| Find all providers in zip 97477 | ||||
| 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 |
|---|---|---|---|---|
| 1386205524 | Quinate Pharmacy LLC | Pharmacy | 1569 Ga Highway 21 S, Springfield, GA 31329-5214 | 2019-06-27 |
| 1295209443 | St Johns Hospital of The Hospital Sisters of The Third Order of St F | Pharmacy | 400 N 9th St Ste 1500, Springfield, IL 62702-5310 | 2019-01-21 |
| 1770093122 | Genoa Healthcare, LLC | Pharmacy | 417 Liberty St Ste 1b, Springfield, MA 01104-3739 | 2017-10-11 |
| 1316483266 | Springfield Clinic, LLP | Pharmacy | 900 N 1st St Rm 4066, Springfield, IL 62702-3749 | 2017-01-17 |
| 1194277681 | Grove Professional Pharmacy, Inc | Pharmacy | 1636 S Glenstone Ave Ste 108, Springfield, MO 65804-1512 | 2016-10-31 |
| 1962852012 | Main Sail Enterprises South LLC | Pharmacy | 222 E Primrose St Ste B, Springfield, MO 65807-5233 | 2016-06-20 |
| 1588042816 | Main Sail Enterprises-downtown LLC | Pharmacy | 655 S Campbell Ave, Springfield, MO 65806-2901 | 2015-05-06 |
| 1972901189 | Fred's Stores of Tennessee Inc | Pharmacy | 1117 Lincoln Park Rd, Springfield, KY 40069 | 2014-12-22 |
| 1417363516 | Springfield Family Pharmacy, Inc | Pharmacy | 175 Carew St, Suite 100, Springfield, MA 01104 | 2014-07-09 |
| 1932529716 | Walgreen Co | Pharmacy | 440 E Tampa St Ste 100, Springfield, MO 65806-1131 | 2014-04-21 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 97477 |
Please comment or provide details below to improve the information on PEACEHEALTH MEDICAL GROUP.
| 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.