ARDON HEALTH, LLC

Provider Demographics

• NPI: 1962832071
• Name: ARDON HEALTH, LLC
• Entity Type: Organization
• Organization Name: ARDON HEALTH, LLC
• Other - Org Name: ARDON HEALTH, LLC
• Other - Org Type: Doing Business As
• Authorized Official - Title/Position: PRESIDENT
• Authorized Official - First Name: HEATHER
• Authorized Official - Last Name: CHAPMAN
• Authorized Official - Phone: 503-444-6529
• Mailing Address - Street 1: 11835 NE GLENN WIDING DR
• Mailing Address - City: PORTLAND
• Mailing Address - State: OR
• Mailing Address - Zip Code: 97220-9057
• Mailing Address - Country: US
• Mailing Address - Phone: 855-425-4101
• Mailing Address - Fax: 855-425-4104
• Practice Address - Street 1: 11835 NE GLENN WIDING DR
• Practice Address - City: PORTLAND
• Practice Address - State: OR
• Practice Address - Zip Code: 97220-9057
• Practice Address - Country: US
• Practice Address - Phone: 855-425-4085
• Practice Address - Fax: 855-425-4096
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2013-11-26
• Last Update Date: 2022-03-09

Provider Licenses

State	License ID	Taxonomies
HI	PMP-1004	3336S0011X
CT	PCN.0002782	3336S0011X
IN	64002411A	3336S0011X
FL	PH28357	3336S0011X
DC	NRX1701250	3336S0011X
IL	054.018529	3336S0011X
CA	NRP2008	3336S0011X
DE	A9-0002058	3336S0011X
ID	46361MS	3336S0011X
AK	PHA-O1385	3336S0011X
KS	22-103391	3336S0011X
CO	OSP.0006445	3336S0011X
IA	4361	3336S0011X
AZ	Y005898	3336S0011X
GA	PHNR000256	3336S0011X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	3336S0011X	Suppliers	Pharmacy	Specialty Pharmacy

Provider Identifiers

State	Identifier ID	ID Type	Issuer
AK	1609651	Medicaid
MT	1962832071	Medicaid
NM	19628790	Medicaid
KY	7100529010	Medicaid
MD	8980063-00	Medicaid
NE	10026742100	Medicaid
ID	1962832071	Medicaid
WA	2034813	Medicaid
SC	7R2854	Medicaid
	2143280	Other	PK
UT	3006801	Medicaid
AZ	365515	Medicaid
CO	9000163242	Medicaid
PA	1035155530001	Medicaid
NC	1962832071	Medicaid
OR	500668204	Medicaid
VA	1962832071	Medicaid