Provider Demographics
NPI:1720403181
Name:VG NEWBERG PHARMACY
Entity Type:Organization
Organization Name:VG NEWBERG PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:ETHERIDGE
Authorized Official - Last Name:HIGDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-352-8553
Mailing Address - Street 1:PO BOX 6149
Mailing Address - Street 2:
Mailing Address - City:ALOHA
Mailing Address - State:OR
Mailing Address - Zip Code:97007-0149
Mailing Address - Country:US
Mailing Address - Phone:503-352-8553
Mailing Address - Fax:503-352-8554
Practice Address - Street 1:2251 E HANCOCK ST
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-2145
Practice Address - Country:US
Practice Address - Phone:971-281-3000
Practice Address - Fax:503-357-0141
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VIRGINIA GARCIA MEMORIAL HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-02-21
Last Update Date:2023-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy