1952542540 NPI number — OREGON HEALTH & SCIENCE UNIVERSITY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952542540 NPI number — OREGON HEALTH & SCIENCE UNIVERSITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OREGON HEALTH & SCIENCE UNIVERSITY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
OHSU RICHMOND CLINIC PHARMACY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952542540
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/17/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3181 SW SAM JACKSON PARK RD
Provider Second Line Business Mailing Address:
MC: 9A13
Provider Business Mailing Address City Name:
PORTLAND
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97239-3011
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-494-8007
Provider Business Mailing Address Fax Number:
503-494-5094

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3930 SE DIVISION ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORTLAND
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97202-1643
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-418-3250
Provider Business Practice Location Address Fax Number:
503-418-3330
Provider Enumeration Date:
03/12/2009

Additional Information

Authorized Official

Authorized Official Last Name:
PHAM
Authorized Official First Name:
YEN
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
503-494-8007

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: RP-0002522-CS , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336I0012X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2118967 . This is a "PK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 500606174 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".




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