Provider Demographics
NPI:1811212798
Name:NEW NARRATIVE PHARMACY
Entity Type:Organization
Organization Name:NEW NARRATIVE PHARMACY
Other - Org Name:FORMERLY LUKE-DORF PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:GRIMM
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:503-597-3904
Mailing Address - Street 1:121 NE 102ND AVE
Mailing Address - Street 2:SUITE 125 BLDG III
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220
Mailing Address - Country:US
Mailing Address - Phone:503-597-3904
Mailing Address - Fax:503-597-3905
Practice Address - Street 1:121 NE 102ND AVE
Practice Address - Street 2:SUITE 125 BLDG III
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220
Practice Address - Country:US
Practice Address - Phone:503-597-3904
Practice Address - Fax:503-597-3905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-02
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care PharmacyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500627213Medicaid
3843794OtherNCPDP
OR104356Medicaid