Provider Demographics
NPI:1497455422
Name:CLINICAL HEALTHCARE EFFECTORS MANAGEMENT
Entity type:Organization
Organization Name:CLINICAL HEALTHCARE EFFECTORS MANAGEMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MENDAZONA
Authorized Official - Suffix:
Authorized Official - Credentials:R PH
Authorized Official - Phone:541-325-2069
Mailing Address - Street 1:16204 SW VAQUEROS WAY
Mailing Address - Street 2:
Mailing Address - City:POWELL BUTTE
Mailing Address - State:OR
Mailing Address - Zip Code:97753
Mailing Address - Country:US
Mailing Address - Phone:541-325-2069
Mailing Address - Fax:
Practice Address - Street 1:1813 W HARVARD AVENUE SUITE 210
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471
Practice Address - Country:US
Practice Address - Phone:541-229-1112
Practice Address - Fax:541-229-1112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-08
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Multi-Specialty
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapyGroup - Multi-Specialty
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory CareGroup - Multi-Specialty