CLINIC PHARMACY
NPI 1801924006
Pharmacy - Community/Retail Pharmacy in Prineville, OR

Q: What is Home Town Drugs Of Prineville Inc's NPI number?

The NPI number for Home Town Drugs Of Prineville Inc is 1801924006. It was assigned to this organization in the NPPES registry on March 1, 2007. The provider is doing business as Clinic Pharmacy.

Q: What is Home Town Drugs Of Prineville Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Active since March 01, 2007CLIA 38D2237456 · Waiver

198 NE COMBS FLAT RD STE 100, PRINEVILLE, OR 97754(541) 447-4111(541) 416-9570 Get Directions Write a Review

NPPES record last updated: December 15, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Clinic Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLINIC PHARMACY (NPI 1801924006) is a healthcare organization registered as a community/retail pharmacy in Prineville, Oregon and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through September 23, 2027 and lists Michael Mendazona, Director, as its authorized official.

NPPES Registry Identity

NPI1801924006

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameHOME TOWN DRUGS OF PRINEVILLE INC

Location Address198 NE COMBS FLAT RD STE 100Prineville, OR 97754-2563

Mailing Address198 Ne Combs Flat Rd Ste 100Prineville, OR 97754-2563 · (541) 447-4111 · Fax (541) 416-9570

Phone(541) 447-4111

Fax(541) 416-9570

Organization SubpartNo

Authorized OfficialMichael MendazonaDirector · (541) 325-1059

Enumeration DateMarch 1, 2007

Last NPPES UpdateDecember 15, 2020

NPPES CertifiedDecember 15, 2020

✔ NPI 1801924006 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

License✔ Licensed in OR · 00430

Definition

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.

Also ListedPharmacyTaxonomy 333600000X

Also ListedPharmacy · Clinic PharmacyTaxonomy 3336C0002X

198 NE COMBS FLAT RD STE 100, Prineville, OR 97754

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Other Names 1

Doing Business AsClinic Pharmacy

Other Identifiers 2

Medicaid228749OR

Other3804273Ncpdp Provider Identification Number

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Antidote Health Plan of Arizona, Inc., Antidote Health Plan of Ohio, Inc., Avera Health Plans and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Clinic Pharmacy is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by February 28, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date

StateOregonEnrollment IDO20120223000819Non-DME Part B · PharmacyDue dateFebruary 28, 2027

Source: CMS Revalidation Due Date List, October 2026 release.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 38D2237456

Clinic Pharmacy · Prineville, OR

Active · expires Sep 23, 2027

CLIA Number38D2237456

Laboratory TypePharmacy

Certificate Effective DateSeptember 24, 2025

Certificate Expiration DateSeptember 23, 2027

Laboratory DirectorSean P. Phothiyane

Laboratory Phone(541) 447-4111

Laboratory LocationClinic Pharmacy198 NE Combs Flat Road, Suite 100, Prineville, OR 97754

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

142 services141 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

120 services119 patients

Severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5ml dosage, for intramuscular use 91304

The COVID-19 vaccine you'll receive is designed to protect against the virus. It contains tiny, harmless pieces of the virus's spike protein. These trigger your immune system to build a defense. The vaccine also includes a saponin-based adjuvant to enhance this response. It's given as a 0.5ml injection into a muscle.

83 services83 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

18 services18 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

14 services14 patients

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ST. CHARLES HEALTH SYSTEM, INC.

Pharmacy (Community/Retail Pharmacy)

198 NE COMBS FLAT RD STE 100
PRINEVILLE, OR 97754

Crook County (541) 706-2972

DR. SEAN P PHOTHIYANE PHARM.D

Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)

198 NE COMBS FLAT RD STE 100
PRINEVILLE, OR 97754

Crook County (541) 447-4111

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Home Town Drugs Of Prineville Inc's NPI number?

The NPI number for Home Town Drugs Of Prineville Inc is 1801924006. It was assigned to this organization in the NPPES registry on March 1, 2007. The provider is doing business as Clinic Pharmacy.

Where is Home Town Drugs Of Prineville Inc located?

Home Town Drugs Of Prineville Inc is located at 198 NE Combs Flat Rd Ste 100, Prineville, OR 97754. The listed phone number is (541) 447-4111.

What is Home Town Drugs Of Prineville Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Is Home Town Drugs Of Prineville Inc enrolled in Medicare?

Yes. Home Town Drugs Of Prineville Inc is registered in the Medicare PECOS enrollment system.

When is Home Town Drugs Of Prineville Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Oregon, Pharmacy) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

Does Home Town Drugs Of Prineville Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 38D2237456) is associated with this NPI, valid through September 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Home Town Drugs Of Prineville Inc accept?

Health plans from Antidote Health Plan of Arizona, Inc., Antidote Health Plan of Ohio, Inc., Avera Health Plans and Moda Health Plan, Inc. list Home Town Drugs Of Prineville Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Home Town Drugs Of Prineville Inc was last updated on December 15, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.