Provider Demographics
NPI:1144343914
Name:UNIVERSITY OF OREGON HEALTH CENTER PHARMACY
Entity type:Organization
Organization Name:UNIVERSITY OF OREGON HEALTH CENTER PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:A
Authorized Official - Last Name:WENDLAND
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:541-346-4454
Mailing Address - Street 1:1232 UNIVERSITY OF OREGON
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97403-1205
Mailing Address - Country:US
Mailing Address - Phone:541-346-4454
Mailing Address - Fax:541-346-2749
Practice Address - Street 1:1590 E 13TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97403-1967
Practice Address - Country:US
Practice Address - Phone:541-346-4454
Practice Address - Fax:541-346-2749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRP-0000196-CS261QS1000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR3801811Medicare UPIN