Organization
CENTRAL CITY CONCERN
Active
Other names
Blackburn Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW B MENDENHALL MD (PRESIDENT & CEO)
(503) 294-1681
Entity
Organization
Contact information
Practice address
12121 E BURNSIDE ST, PORTLAND, OR 97216-3737
(971) 361-7700
Mailing address
121 NW EVERETT ST, PORTLAND, OR 97209-4049
(503) 294-1681
(503) 294-4321
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
3336C0002X
Clinic Pharmacy
Primary
—
—
Other
Enumeration date
10/10/2018
Last updated
04/09/2026
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