Gresham Professional Pharmacy in Gresham - Pharmacist
Gresham Professional Pharmacy - NPI 1063401198
Gresham Professional Pharmacy is a Pharmacist in Gresham, Oregon. Gresham Professional Pharmacy practices all healthcare services and medical treatments related to Pharmacist. The NPI Number for Gresham Professional Pharmacy is 1063401198. The last update date is 2008-10-21.
Gresham Professional Pharmacy's current location address is 24076 Se Stark St, Gresham, Oregon. You can contact this provider via phone number 5034910117 and fax number 5034892078. The mailing address for Gresham Professional Pharmacy is 24076 Se Stark St, Gresham, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Gresham Professional Pharmacy |
|---|---|
| Address | 24076 Se Stark St, Gresham, Oregon |
| Phone Number | 5034910117 |
| Fax Number | 5034892078 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CEO |
|---|---|
| Authorized Official Name | Moll G David |
| Credentials | PHARMD |
| Telephone Number | 5034910117 |
NPI Number Detail
| NPI Number | 1063401198 |
|---|---|
| Provider Enumeration Date | 2005-10-20 |
| Last Updated Date | 2008-10-21 |
Provider Mailing Address Detail
| Address | 24076 Se Stark St |
|---|---|
| City | Gresham |
| State | Oregon (OR) |
| Post Code | 970303373 |
| Phone Number | 5034910117 |
| Fax Number | 5034892078 |
Provider's Primary Taxonomy Detail
| Speciality | Pharmacist |
|---|---|
| Taxonomy | 183500000X |
| Licence No | 8305 |
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Definition: An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or m |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 299911 | OR | -- | |
| 3815125 | OR | NABP/NCPDP # |
Post Comment/ Review Below
What is the unique identifier code issued to Gresham Professional Pharmacy by the Centers for Medicare & Medicaid Services?
The Gresham Professional Pharmacy has been assigned the NPI (National Provider Identifier) 1063401198. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Gresham Professional Pharmacy is physically located?
The Gresham Professional Pharmacy is situated at the following address: 24076 Se Stark St, Gresham, OR 970303373.
What is Gresham Professional Pharmacy's area of expertise and its corresponding taxonomy classification?
The Gresham Professional Pharmacy's field of specialization is Pharmacist, and it falls under the taxonomy code 183500000X, which categorizes healthcare providers based on their areas of practice.
On what date did Gresham Professional Pharmacy receive its 1063401198 assignment from the Centers for Medicare & Medicaid Services?
The Gresham Professional Pharmacy was assigned its 1063401198 on 2005-10-20, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information related to Gresham Professional Pharmacy most recently updated or refreshed?
The details pertaining to the Gresham Professional Pharmacy, including its address, specialty, and other relevant information, were last updated or refreshed on 2008-10-21.
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