LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER NPI 1609896174

NPI Information

  • NPI: 1609896174
  • Provider Name: LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER
  • Classification: Pharmacy - 3336C0003X
  • Specialization: Community/Retail Pharmacy
  • Entity Type: Organization
  • CLIA Number: 38D1090706
  • Address: 1040 NW 22ND AVE
    SUITE 100
    PORTLAND, OR
    ZIP 97210
  • Phone: (503) 413-8122

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NPI Details

LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER is a community/retail pharmacy pharmacy in Portland, OR. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER NPI is 1609896174. The provider is registered as an organization entity type.

The provider's business location address is:

1040 NW 22ND AVE
SUITE 100
PORTLAND, OR
ZIP 97210-057
Phone: (503) 413-8122

The provider's authorized official is Sarah Jensen .
The authorized official title is Vp Finance and has the following contact phone number (503) 415-5145.

The CLIA number assigned to this NPI record is 38D1090706 - ancillary testing site in health care center with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Influenza vaccine, quadrivalent derived from recombinant dna (HCPCS:90682)

The enumeration date for this NPI number is 7/20/2006 and was last updated on 10/30/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336C0003XPharmacyCommunity/Retail PharmacyRP-0001427-CSOREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
13806051OTHEROREGONNCPDP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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