# LEGACY MOUNT HOOD MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LEGACY MOUNT HOOD MEDICAL CENTER
- **Other names:** Legacy Mount Hood Medical Center Pharmacy
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1992725477
- **Legal business name:** LEGACY MOUNT HOOD MEDICAL CENTER
- **Authorized official:** LINDA S HOFF (SR VP AND CFO)
- **Authorized official phone:** (503) 415-5730

## Contact information

- **Practice address:** 24800 SE STARK ST, GRESHAM, OR 97030-3378
- **Practice address phone:** (503) 674-1230
- **Mailing address:** PO BOX 4037, PORTLAND, OR 97208-4037
- **Mailing address phone:** (503) 413-3958

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | IP-000221-CS | OR | Yes |

## Other

- **Enumeration date:** 07/20/2006
- **Last updated:** 02/17/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 3808954 | NCPDP | OR |