ROGUE VALLEY MANOR PHARMACY
NPI 1265572150
Pharmacy - Community/Retail Pharmacy in Medford, OR

NPI Status: Active since February 08, 2007

Contact Information

1250 MIRA MAR AVE
MEDFORD, OR
ZIP 97504
Phone: (541) 857-7361
Fax: (541) 857-7362

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  • Organization
  • Pharmacy
  • Community/Retail Pharmacy
  • Accepts Insurance
  • CLIA Number: 38D2257328
  • CLIA Cert. Type: Assisted Living Facility
  • CLIA Exp. Date: 04-03-2028

About ROGUE VALLEY MANOR PHARMACY

This page provides the complete NPI Profile along with additional information for Rogue Valley Manor Pharmacy, a provider established in Medford, Oregon operating as a Pharmacy, focusing in community/retail pharmacy . The healthcare provider is registered in the NPI registry with number 1265572150 assigned on February 2007. The practitioner's primary taxonomy code is 3336C0003X with license number RP0000882 (OR). The provider is registered as an organization and their NPI record was last updated 10 years ago. The provider's is doing business as Rogue Valley Manor Pharmacy. The authorized official of this NPI record is Fred Millan Rph (Director Of Pharmacy)

NPI
1265572150
Provider Legal Name
ROGUE VALLEY MANOR
Other Organization Name
ROGUE VALLEY MANOR PHARMACY
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
1250 MIRA MAR AVE MEDFORD, OR 97504
Location Phone
(541) 857-7361
Location Fax
(541) 857-7362
Mailing Address
1250 MIRA MAR AVE MEDFORD, OR 97504
Mailing Phone
(541) 857-7361
Mailing Fax
(541) 857-7362
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
02-08-2007
Last Update Date
04-11-2016
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pharmacy Community/Retail Pharmacy

Taxonomy Code
3336C0003X
Type
Suppliers
License No.
RP0000882
License State
OR
Taxonomy Description
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1333600000XSuppliers

Pharmacy

 
23336I0012XSuppliers

Pharmacy
Institutional Pharmacy

 
33336L0003XSuppliers

Pharmacy
Long Term Care Pharmacy

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Balance by Medica Bronze $0 Copay PCP Visits - EPO
  • Balance by Medica Bronze $0 Copay PCP Visits - PPO
  • Balance by Medica Bronze Premier - EPO
  • Balance by Medica Bronze Premier - PPO
  • Balance by Medica Expanded Bronze Standard - EPO
  • Balance by Medica Expanded Bronze Standard - PPO
  • Balance by Medica Gold $0 Copay PCP Visits - EPO
  • Balance by Medica Gold $0 Copay PCP Visits - PPO
  • Balance by Medica Gold Share - EPO
  • Balance by Medica Gold Share - PPO
  • Balance by Medica Gold Standard - EPO
  • Balance by Medica Gold Standard - PPO
  • Balance by Medica Silver $0 Copay PCP Visits - EPO
  • Balance by Medica Silver $0 Copay PCP Visits - PPO
  • Balance by Medica Silver Share - EPO
  • Balance by Medica Silver Share - PPO
  • Balance by Medica Silver Standard - EPO
  • Balance by Medica Silver Standard - PPO
  • Elevate by Medica Bronze $0 Copay PCP Visits - EPO
  • Elevate by Medica Bronze Premier - EPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

FRED MILLAN RPH

Authorized Official Title
DIRECTOR OF PHARMACY
Authorized Official Phone
(541) 857-7361

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
2078260OTHER (01)PK
385250MEDICAID (05)OR 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
38D2257328
Facility Type
Assisted Living Facility
Certificate Effective Date
April 04, 2026
Certificate Expiration Date
April 03, 2028
Laboratory Director
MARY HOLLINGER
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Rogue Valley Manor Pharmacy to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1265572150, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 50. The final step is to find the difference between that total and the next multiple of ten (50 - 50 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
5
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
7
Unchanged
Pos 7
2
Doubled → 4
Pos 8
1
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 5 → 10 → 1 2 → 4 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 2 + 5 + 1 + 0 + 7 + 4 + 1 + 1 + 0 + 24 = 50

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 50 is 50. The difference is the calculated check digit.

50 - 50 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1265572150.

Other Providers at the Same Location


The following 5 providers are registered at the same or a nearby location.

Family Medicine
1250 MIRA MAR AVE
MEDFORD, OR 97504
Nurse Practitioner
1250 MIRA MAR AVE
MEDFORD, OR 97504
Internal Medicine
1250 MIRA MAR AVE
MEDFORD, OR 97504
Nurse Practitioner (Family)
1250 MIRA MAR AVE
MEDFORD, OR 97504
Occupational Therapist
1250 MIRA MAR AVE
MEDFORD, OR 97504

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1265572150, enumerated as an "organization" on February 08, 2007.

The provider is located at 1250 MIRA MAR AVE MEDFORD, OR 97504 and the phone number is (541) 857-7361.

Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.

The provider might be accepting Accepts: Medica, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.