MEDICARE: PHARMACY1ST LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy	00917	OR
2	3336C0003X	Community/Retail Pharmacy	00917	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	3810707	OTHER	OR	NCPDP NUMBER
3	1336158385	OTHER		NPI

General Provider Information

NPI Number	:	1336158385
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHARMACY1ST LLC

Provider Business Mailing Address
First Line	:	808 2ND AVE
Second Line	:
City	:	GOLD HILL
State	:	OR
Zip	:	97525-5502
Country	:	US
Telephone Number	:	541-855-1544
Fax Number	:	541-855-1040

Provider Business Practice Location Address
First Line	:	808 SECOND AVE.
Second Line	:
City	:	GOLD HILL
State	:	OR
Zip	:	97525
Country	:	US
Telephone Number	:	541-885-1544
Fax Number	:	541-855-1040

Authorized Official
Title or Position	:	HEAD OF PHARMACY SERVICES
Name	:	DR. SETH KOSSI ANATO
Credential	:	PHARMD
Telephone Number	:	541-855-1544

Provider Enumeration Date	:	08/07/2006
Last Update Date	:	02/16/2026

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Directions to “PHARMACY1ST LLC ” Practice Location

Language	Start Address	Practice Location

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