Healthcare Provider Details

I. General information

NPI: 1144343914
Provider Name (Legal Business Name): UNIVERSITY OF OREGON HEALTH CENTER PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 01/03/2022
Certification Date: 01/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1590 E 13TH AVE
EUGENE OR
97403-1967
US

IV. Provider business mailing address

1232 UNIVERSITY OF OREGON
EUGENE OR
97403-1205
US

V. Phone/Fax

Practice location:
  • Phone: 541-346-4454
  • Fax: 541-346-2749
Mailing address:
  • Phone: 541-346-4454
  • Fax: 541-346-2749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License NumberRP-0000196-CS
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. GREGG A WENDLAND
Title or Position: PHARMACY MANAGER
Credential: RPH.
Phone: 541-346-4454