Provider Demographics
NPI:1467090183
Name:MOSAIC COMMUNITY HEALTH
Entity Type:Organization
Organization Name:MOSAIC COMMUNITY HEALTH
Other - Org Name:MOSAIC PHARMACY - PRINEVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:STRANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-383-3005
Mailing Address - Street 1:375 NW BEAVER ST STE 103
Mailing Address - Street 2:
Mailing Address - City:PRINEVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97754-1802
Mailing Address - Country:US
Mailing Address - Phone:541-383-3852
Mailing Address - Fax:541-383-1883
Practice Address - Street 1:375 NW BEAVER ST STE 103
Practice Address - Street 2:
Practice Address - City:PRINEVILLE
Practice Address - State:OR
Practice Address - Zip Code:97754-1802
Practice Address - Country:US
Practice Address - Phone:541-383-3852
Practice Address - Fax:541-383-1883
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOSAIC COMMUNITY HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-12
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy