Provider Demographics
NPI:1700321825
Name:LEGACY EMANUEL HOSPITAL AND HEALTH CENTER
Entity Type:Organization
Organization Name:LEGACY EMANUEL HOSPITAL AND HEALTH CENTER
Other - Org Name:UNITY CENTER FOR BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:VORRATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-944-7731
Mailing Address - Street 1:UNITY CENTER FOR BEHAVIORAL HEALTH
Mailing Address - Street 2:1225 NE 2ND ST
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232
Mailing Address - Country:US
Mailing Address - Phone:503-944-7731
Mailing Address - Fax:503-944-7730
Practice Address - Street 1:UNITY CENTER FOR BEHAVIORAL HEALTH
Practice Address - Street 2:1225 NE 2ND ST
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232
Practice Address - Country:US
Practice Address - Phone:503-944-7731
Practice Address - Fax:503-944-7730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-28
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2167669OtherPK