Provider Demographics
NPI:1275922239
Name:DHS/OFFICE OF FINANCIAL SERVICES IRS/EOPC/BMRC/EOTC/OSH/OSH-P
Entity Type:Organization
Organization Name:DHS/OFFICE OF FINANCIAL SERVICES IRS/EOPC/BMRC/EOTC/OSH/OSH-P
Other - Org Name:OREGON STATE HOSPITAL JUNCTION CITY CAMPUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMIESON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-572-7663
Mailing Address - Street 1:2600 CENTER ST NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-2682
Mailing Address - Country:US
Mailing Address - Phone:503-945-9840
Mailing Address - Fax:
Practice Address - Street 1:29398 RECOVERY WAY
Practice Address - Street 2:
Practice Address - City:JUNCTION CITY
Practice Address - State:OR
Practice Address - Zip Code:97448-8447
Practice Address - Country:US
Practice Address - Phone:541-465-2945
Practice Address - Fax:541-465-2647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-14
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORIP00022583336I0012X
3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR3845469OtherNCPDP