Providence Specialty Pharmacy Services-Infusion/Spp

LBN: Providence Health & Services Oregon
Providence Specialty Pharmacy Services-Infusion/Spp is an health care organization with primary practice located at 6410 Ne Halsey St Suite 400, Portland OR 97213-4742. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Parenteral & Enteral Nutrition, Suppliers / Home Infusion Therapy Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Home Infusion Therapy Pharmacy is the primary health care specialty. Providence Health & Services Oregon can be contacted via phone (503) 215-4652, or through Anderson, Donald Wayne via phone (425) 525-5392.

Contact Information

Primary practice address
6410 Ne Halsey St Suite 400 Portland OR 97213-4742
Phone: (503) 215-4652
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Anderson, Donald Wayne
Phone: (425) 525-5392

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Parenteral & Enteral Nutrition 332BP3500X
Suppliers / Home Infusion Therapy Pharmacy 3336H0001X RP-0001136-CS Oregon
Suppliers / Specialty Pharmacy 3336S0011X RP-0001136-CS Oregon

Profile Details

NPI number 1427132265
LBN Legal business name Providence Health & Services Oregon
DBA Doing business as Providence Specialty Pharmacy Services-Infusion/Spp
Authorized official Anderson, Donald Wayne
Entity Organization
Organization subpart 1 Yes
Enumeration date Oct 25th, 2006
Last updated May 6th, 2021 - about 3 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 1427132265 NPPES
Washington MEDICAID 1044161
Washington MEDICAID 032016
Washington MEDICAID 1427132265
Washington MEDICAID 1427132265
Washington MEDICAID PH001OR
Washington MEDICAID 1427132265

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