NPI 1174666358 · live from the CMS NPI Registry
Confederated Tribes Of The Grand Ronde Community Of Oregon
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in Grand Ronde, OR. National Provider Identifier 1174666358, active.
NPI record
| NPI | 1174666358 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X |
| Practice location | 9605 Grand Ronde Rd, Grand Ronde, OR 97347 |
| Practice phone | 503-879-2236 |
| Mailing address | Po Box 338, Grand Ronde, OR 97347 |
| Enumerated | February 15, 2007 |
| Last updated | February 28, 2024 |
| Authorized official | Kelly Rowe, Executive Director Health Services |
| Other names | Grand Ronde Health And Wellness Center; Great Circle Recovery |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist | 152W00000X | — |
| General Practice | 208D00000X | — |
| Clinic/Center, Community Health | 261QC1500X | — |
| Clinic/Center, Federally Qualified Health Center (FQHC) | 261QF0400X | 126883 (OR) |
| Clinic/Center, Radiology | 261QR0200X | 445142 (OR) |
| Clinical Medical Laboratory | 291U00000X | 38D0862855 (OR) |
| Counselor | 101Y00000X | — |
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | — |
| Chiropractor | 111N00000X | — |
| Dentist, General Practice | 1223G0001X | — |
| Pharmacy | 333600000X | 1559 (OR) |
| Nurse Practitioner, Family | 363LF0000X | — |
| Nurse Practitioner, Primary Care | 363LP2300X | — |
| Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy primary | 332800000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.