Everetts Villa Pharmacy

LBN: David Jorgensen
Everetts Villa Pharmacy is an health care organization with primary practice located at 1755 Coburg Rd , Eugene OR 97401. The organization recently has 5 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy, Suppliers / Mail Order Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. David Jorgensen can be contacted via phone (541) 343-8861, or through Jorgensen, David via phone (541) 343-8861.

Contact Information

Primary practice address
1755 Coburg Rd Eugene OR 97401
Phone: (541) 343-8861
Fax: (541) 465-1392
Website:
Map and Directions
Authorized official contact:
Name: Jorgensen, David
Phone: (541) 343-8861

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X 00182 Oregon
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X
Suppliers / Community/Retail Pharmacy 3336C0003X 00182 Oregon
Suppliers / Long Term Care Pharmacy 3336L0003X
Suppliers / Mail Order Pharmacy 3336M0002X

Profile Details

NPI number 1154433167
LBN Legal business name David Jorgensen
DBA Doing business as Everetts Villa Pharmacy
Authorized official Jorgensen, David
Entity Organization
Organization subpart 1 No
Enumeration date Aug 31st, 2006
Last updated Mar 7th, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154433167 NPPES
Other 1180250001 DMERC
MEDICAID 170922 DMERC
Other 3801657 DMERC

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