Organization
PEACEHEALTH NETWORKS ON DEMAND, LLC
Active
Parent organization
PEACEHEALTH NETWORKS ON DEMANDS, LLC
Other names
ZoomCare-Broadway & 33rd
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEACEHEALTH NETWORKS ON DEMANDS, LLC
Authorized official
DR. MALLORY ALYSE KEMPTON-HEIN PHARM D. (PHARMACIST)
(503) 941-3807
Entity
Organization
Contact information
Practice address
3218 NE BROADWAY ST, PORTLAND, OR 97232-1815
(503) 941-3807
(503) 941-3809
Mailing address
1455 NW IRVING ST STE 600, PORTLAND, OR 97209-2277
(503) 941-3807
(503) 941-3809
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000028-CS
SUPERVISING PHYSICIAN DISPENSING OUTLET
OR
Enumeration date
07/31/2020
Last updated
07/31/2020
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