Oregon CVS Pharmacy LLC
NPI 1063090710ActiveOrganization· Pharmacy· Lake Oswego, OR
Pharmacy in Lake Oswego, Oregon, registered in NPPES in April 2021. The authorized official on file is Susan Colbert, Sr Director, Payer Relations. Medicare paid $124,663 for services to 440 patients in 2024.
Overview
| NPI | 1063090710 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 1, 2021 |
| Last updated in NPPES | May 12, 2021 |
| Certified by provider | May 12, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | — | — |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — |
| Pharmacy, Community/Retail Pharmacy | 3336C0003X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Pharmacy (OR) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 440 |
|---|---|
| Services billed | 1,542 across 12 procedure codes |
| Paid by Medicare | $124,663 |
Other Pharmacy providers in Lake Oswego
- 1730298027
- 1841232089