Gresham Professional Pharmacy
NPI 1063401198 · Community/Retail Pharmacy · Gresham, OR
Gresham Professional Pharmacy is a Community/Retail Pharmacy organization in Gresham, OR (NPI 1063401198).
Provider details
- NPI number
- 1063401198
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- David Moll, Ceo(503) 491-0117
- License
- 8305 (OR)
Specialties & taxonomies
Suppliers
Pharmacy Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2005-10-20
- Last updated
- 2008-10-21
Frequently asked questions
- What is Gresham Professional Pharmacy's NPI number?
- Gresham Professional Pharmacy's National Provider Identifier (NPI) is 1063401198, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Gresham Professional Pharmacy?
- Gresham Professional Pharmacy is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Gresham Professional Pharmacy located?
- Gresham Professional Pharmacy's practice location on file with NPPES is 24076 Se Stark St, Gresham, OR 97030-3373.
- What is Gresham Professional Pharmacy's phone number?
- The practice phone number listed in the NPPES registry for Gresham Professional Pharmacy is (503) 491-0117.
- Who is the authorized official for Gresham Professional Pharmacy?
- The authorized official listed on Gresham Professional Pharmacy's NPPES record is David Moll, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Gresham Professional Pharmacy's NPI active?
- Yes — Gresham Professional Pharmacy's NPI (1063401198) is active in the NPPES registry as of the last update on 2008-10-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.