NPI 1114230331 · live from the CMS NPI Registry
Central City Concern
Pharmacy, Clinic Pharmacy in Portland, OR. National Provider Identifier 1114230331, active.
NPI record
| NPI | 1114230331 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Pharmacy, Clinic Pharmacy 3336C0002X |
| Practice location | 727 W Burnside St, Portland, OR 97209 |
| Practice phone | 503-944-4465 |
| Mailing address | 121 Nw Everett St, Portland, OR 97209 |
| Enumerated | July 16, 2010 |
| Last updated | April 9, 2026 |
| Authorized official | Andrew Mendenhall, President & Ceo |
| Other names | Old Town Clinic Pharmacy |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pharmacy, Clinic Pharmacy primary | 3336C0002X | RP0002607-CS (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.