PROCARE PHARMACY L.L.C. NPI 1558470039

NPI Information

NPI: 1558470039
Provider Name: PROCARE PHARMACY, L.L.C.
Classification: Pharmacy - 333600000X
Entity Type: Organization
Doing Business As: CVS PHARMACY # 02819
CLIA Number: 38D2315753
Address: 1309 NW 23RD AVE
PORTLAND, OR
ZIP 97210
Phone: (800) 850-5329

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NPI Details

PROCARE PHARMACY, L.L.C. is a pharmacy in Portland, OR. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. PROCARE PHARMACY, L.L.C. NPI is 1558470039. The provider is registered as an organization entity type.
The provider Is Doing Business As Cvs Pharmacy # 02819.

The provider's business location address is:

1309 NW 23RD AVE
PORTLAND, OR
ZIP 97210-601
Phone: (800) 850-5329

The provider's authorized official is Susan Colbert .
The authorized official title is Director, Payer Relations and has the following contact phone number (401) 770-2751.

The CLIA number assigned to this NPI record is 38D2315753 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/29/2006 and was last updated on 1/31/2021.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332B00000X	Durable Medical Equipment & Medical Supplies				No
2	3336C0003X	Pharmacy	Community/Retail Pharmacy			No
3	3336S0011X	Pharmacy	Specialty Pharmacy			No
4	333600000X	Pharmacy		00368	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3813830	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

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: 11/21/2025

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