SENIOR PHARMACY, LLC (NPI# 1942257043) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942257043 |
| Entity Type | Organization |
| Organization Name | SENIOR PHARMACY, LLC |
| Practice Address |
28717 Grumman Dr Eugene OR 97402-9542 |
| Practice Telephone | 5416072000 |
| Practice Fax Number | 5412848232 |
| Mailing Telephone | 5416072000 |
| Mailing Fax Number | 5412848232 |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | SCOTT BERGER (DIRECTOR, BUSINESS OPERATIONS) |
| Authorized Official Telephone | 5416072000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 310400000X | Assisted Living Facility | RP-0002006-CS | OR | Nursing & Custodial Care Facilities |
| X | 314000000X | Skilled Nursing Facility | IP-0001818-CS | OR | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 227137 | 05 | |
| OR | 227136 | 05 | |
| OR | NCPDP | 3814034 | 01 |
| OR | DEA | BS6870415 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | SENIOR PHARMACY, LLC |
| Street Address |
28717 GRUMMAN DR |
| City | EUGENE |
| State | OR |
| Zip Code | 97402-9542 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790196343 | Thomas Britton | Pharmacist | 28717 Grumman Dr, Eugene, OR 97402-9542 | 2014-05-16 |
| 1467862110 | Katherine Fortner | Pharmacist | 28717 Grumman Dr, Eugene, OR 97402-9542 | 2014-05-04 |
| 1427241900 | Glenn Ellsworth Conway Jr. | Pharmacist | 28717 Grumman Dr, Eugene, OR 97402-9542 | 2007-08-20 |
| 1114118635 | Richard James Prout | Pharmacist | 28717 Grumman Dr, Eugene, OR 97402-9542 | 2007-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538709704 | Jordan Charles Smith | Massage Therapist | 775 Menroe St., Eugene, OR 97402 | 2020-01-15 |
| 1104462134 | Cerridwen Laurel Martin | Massage Therapist | 775 Monroe St., Eugene, OR 97402 | 2019-11-25 |
| 1720556368 | Valerie Jeanne Charles | Massage Therapist | 989 Throne Dr., Eugene, OR 97402 | 2018-11-12 |
| 1407324189 | Laura Angulo | Massage Therapist | 1247 W 8th Ave Apt 10, Eugene, OR 97402 | 2018-11-11 |
| 1932687472 | Karl Alan Porter | Counselor | 1195 City View St Ste B, Eugene, OR 97402 | 2018-08-06 |
| 1992283170 | Fresenius Medical Care Dialysis Services - Oregon, LLC | Clinic/Center | 3747 W 11th Ave, Eugene, OR 97402 | 2018-07-31 |
| 1699251744 | Isabella Arlo Jane Silver | Counselor | 970 W 7th Ave., Eugene, OR 97402 | 2018-07-12 |
| 1447740527 | Shasta Tobi Cooke | Behavioral Analyst | 677 1/2 W 12th Ave, Eugene, OR 97402 | 2018-05-15 |
| 1497205306 | Jenna Bracco | Social Worker | 1274 W. 7th Avenue Suite 201, Eugene, OR 97402 | 2016-10-04 |
| 1871041392 | Jeremy Powers | Massage Therapist | 882 Van Buren St, Eugene, OR 97402 | 2016-09-13 |
| Find all providers in zip 97402 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902138712 | Midwest Care Angelwood, LLC | Assisted Living Facility | 78 Centennial Loop, Eugene, OR 97401-7900 | 2010-02-03 |
| 1902067036 | Eugene Lane Associates | Assisted Living Facility | 4550 W Amazon Dr, Eugene, OR 97405-5232 | 2008-06-20 |
| 1114106432 | Regency of Fox Hollow, Inc | Assisted Living Facility | 5320 Fox Hollow Rd, Eugene, OR 97405-4049 | 2007-11-02 |
| 1518154897 | Assisted Living Concepts Inc | Assisted Living Facility | 1155 Darlene Lane, Eugene, OR 97401 | 2007-10-01 |
| 1679792428 | Barger Road Cottages, LLC | Assisted Living Facility | 3850 Everest Loop, Eugene, OR 97402 | 2007-04-24 |
| 1982724902 | Alpine Spings IIi, LLC | Assisted Living Facility | 3760 N Clarey St, Eugene, OR 97402-8744 | 2007-03-31 |
| 1669599460 | Harder Development IIi, LLC | Assisted Living Facility | 2615 Lone Oak Way, Eugene, OR 97404-2554 | 2007-03-25 |
| 1407472194 | Lone Oak Al, LLC | Assisted Living Facility | 2615 Lone Oak Way, Eugene, OR 97404-2554 | 2020-06-18 |
| 1568005213 | Csl - Eugene II, LLC | Assisted Living Facility | 3760 N Clarey St, Eugene, OR 97402-8744 | 2019-10-25 |
| 1679116313 | Csl - Eugene I, LLC | Assisted Living Facility | 3720 N Clarey St, Eugene, OR 97402-8744 | 2019-10-25 |
| Find all providers in EUGENE | ||||
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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.