GRESHAM PROFESSIONAL PHARMACY – Community/Retail Pharmacy, NPI 1063401198

GRESHAM PROFESSIONAL PHARMACY is a healthcare provider. based in Gresham, Oregon. specializing in Community/Retail Pharmacy. The organization holds a License No. 8305 (OR). The NPI Number for GRESHAM PROFESSIONAL PHARMACY is 1063401198

Main info

Organization
Name
GRESHAM PROFESSIONAL PHARMACY
NPI
1063401198
Phone
(503) 491-0117
Address
24076 SE STARK ST
Authorized Official
DR. DAVID G MOLL CEO PHARMD
Enumeration Date
20 October 2005
Last Update Date
21 October 2008
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience63
Completeness75
Years active:20State licenses:2Digital endpointsOther names

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Provider Addresses for GRESHAM PROFESSIONAL PHARMACY

  • Southeast Stark Street, Northeast, Gresham, Multnomah County, Oregon, 97060, United States

    SUITE 100

    GRESHAM, OR 970303373

    Phone: (503) 491-0117

    Fax: (503) 489-2078

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97030)

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Reviews

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Frequently asked questions

What NPI should I save for GRESHAM PROFESSIONAL PHARMACY?
Save NPI 1063401198 if you need a stable reference for GRESHAM PROFESSIONAL PHARMACY.
Is GRESHAM PROFESSIONAL PHARMACY currently active in the NPI registry?
CMS-published data lists GRESHAM PROFESSIONAL PHARMACY as an active registrant.
Does GRESHAM PROFESSIONAL PHARMACY list a primary specialty?
If you are matching referrals, note Community/Retail Pharmacy for GRESHAM PROFESSIONAL PHARMACY. Clinical services aligned with this taxonomy classification.
Where is GRESHAM PROFESSIONAL PHARMACY's primary listing?
We display Gresham, Oregon because that is what the record indicates for GRESHAM PROFESSIONAL PHARMACY.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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