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NPI 1992553598 · live from the CMS NPI Registry

1918 Winter Street Operating Co LLC

Pharmacy, Community/Retail Pharmacy in Gladstone, OR. National Provider Identifier 1992553598, active.

NPI record

NPI1992553598 Type 2 · organization
StatusActive
Primary specialtyPharmacy, Community/Retail Pharmacy 3336C0003X
Practice location95 82nd Dr, Gladstone, OR 97027
Practice phone503-723-2685
Mailing address7 Corporate Dr, Keene, NH 03431
EnumeratedMay 8, 2024
Last updatedJuly 24, 2024
Authorized officialKevin Mcnamara, Authorized Person
Other namesSafeway Pharmacy #4387

Taxonomies and licenses

TaxonomyCodeLicense
Durable Medical Equipment & Medical Supplies332B00000X—
Pharmacy, Community/Retail Pharmacy primary3336C0003X—

Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.