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CENTRAL CITY CONCERN NPI 1114230331


NPI Information

NPI: 1114230331
Provider Name: CENTRAL CITY CONCERN

Doing Business As: OLD TOWN CLINIC PHARMACY

Classification: Pharmacy - 3336C0002X
Entity Type: Organization

Specialization: Clinic Pharmacy

CLIA Number: 38D0623645

Address:
727 W BURNSIDE ST
PORTLAND, OR
ZIP 97209
Phone: (503) 944-4465
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CENTRAL CITY CONCERN is a clinic pharmacy pharmacy in Portland, OR. The provider is a pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. CENTRAL CITY CONCERN NPI is 1114230331. The provider is registered as an organization entity type.
The provider Is Doing Business As Old Town Clinic Pharmacy.

The provider's business location address is:

727 W BURNSIDE ST
PORTLAND, OR
ZIP 97209-514
Phone: (503) 944-4465
Fax: (971) 271-6124

The provider's authorized official is Andrew Mendenhall .
The authorized official title is President & Ceo and has the following contact phone number (503) 294-1681.

The CLIA number assigned to this NPI record is 38D0623645 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/16/2010 and was last updated on 3/6/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13336C0002XPharmacyClinic PharmacyRP0002607-CSOREGONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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