Provider Demographics
NPI:1790375848
Name:COORDINATED MEDUCATION TEAM LLC
Entity Type:Organization
Organization Name:COORDINATED MEDUCATION TEAM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/CONSULTANT PHARMACIST FOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:A
Authorized Official - Last Name:VAN HORN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:503-530-8657
Mailing Address - Street 1:10865 SW HIGHLAND DRIVE
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97224-3510
Mailing Address - Country:US
Mailing Address - Phone:503-530-8657
Mailing Address - Fax:503-530-8657
Practice Address - Street 1:10865 SW HIGHLAND DRIVE
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97224-3510
Practice Address - Country:US
Practice Address - Phone:503-530-8657
Practice Address - Fax:503-530-8657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapyGroup - Single Specialty