Southeast Health Clinic Pharmacy

LBN: Multnomah County Oregon
Southeast Health Clinic Pharmacy is an health care organization with primary practice located at 3653 Se 34Th Ave , Portland OR 97202-3034. The organization recently has only one registered license in Suppliers / Clinic Pharmacy, which is considered as the primary health care specialty. Multnomah County Oregon can be contacted via phone (503) 988-5423, or through Koder, Michele via phone (503) 988-7278.

Contact Information

Primary practice address
3653 Se 34Th Ave Portland OR 97202-3034
Phone: (503) 988-5423
Fax: (503) 988-4345
Website:
Map and Directions
Authorized official contact:
Name: Koder, Michele
Phone: (503) 988-7278

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Clinic Pharmacy 3336C0002X RP-0002772-CS Oregon

Profile Details

NPI number 1396087631
LBN Legal business name Multnomah County Oregon
DBA Doing business as Southeast Health Clinic Pharmacy
Authorized official Koder, Michele
Entity Organization
Organization subpart 1 No
Enumeration date Mar 25th, 2013
Last updated Nov 8th, 2019 - about 5 years ago

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 1396087631 NPPES
Other 3844621 NCPDP PROVIDER IDENTIFICATION NUMBER
MEDICAID 123620 NCPDP PROVIDER IDENTIFICATION NUMBER

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