Providence Bridgeport Pharmacy

LBN: Providence Health & Services Oregon
Providence Bridgeport Pharmacy is an health care organization with primary practice located at 18040 Sw Lower Boones Ferry Rd Ste 104 , Tigard OR 97224-7259. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Providence Health & Services Oregon can be contacted via phone (503) 216-0625, or through Williams, Rebecca via phone (503) 215-8584.

Contact Information

Primary practice address
18040 Sw Lower Boones Ferry Rd Ste 104 Tigard OR 97224-7259
Phone: (503) 216-0625
Fax: (503) 216-0630
Website:
Map and Directions
Authorized official contact:
Name: Williams, Rebecca
Phone: (503) 215-8584

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X RP-0002571-CS Oregon

Profile Details

NPI number 1922330828
LBN Legal business name Providence Health & Services Oregon
DBA Doing business as Providence Bridgeport Pharmacy
Authorized official Williams, Rebecca
Entity Organization
Organization subpart 1 No
Enumeration date Feb 3rd, 2010
Last updated Feb 22nd, 2010 - about 15 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 1922330828 NPPES
Other 3843768 NCPDP PROVIDER IDENTIFICATION NUMBER

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