PROVIDENCE HEALTH & SERVICES OREGON NPI 1952495772

NPI Information

NPI: 1952495772
Provider Name: PROVIDENCE HEALTH & SERVICES OREGON

Doing Business As: PROV HEALTH SYS-OR SHARED-SVS DIV

Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

Address:
2033 COMMERCE DR
MEDFORD, OR
ZIP 97504
Phone: (541) 732-6500
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PROVIDENCE HEALTH & SERVICES OREGON is a hospice care community based in Medford, OR. PROVIDENCE HEALTH & SERVICES OREGON NPI is 1952495772. The provider is registered as an organization entity type.
The provider Is Doing Business As Prov Health Sys-or Shared-svs Div.

The provider's business location address is:

2033 COMMERCE DR
MEDFORD, OR
ZIP 97504-744
Phone: (541) 732-6500

The provider's authorized official is Donald Wayne Anderson .
The authorized official title is Asst Corp Secretary For Enrollments and has the following contact phone number (425) 525-5392.

The CLIA number assigned to this NPI record is 38D0681033 - home health agency with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/3/2006 and was last updated on 12/29/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251G00000X	Hospice Care, Community Based				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	026699000	OTHER	OREGON	BLUE CROSS FFS
2	930386912-03	OTHER	OREGON	ODS
3	303804000001	OTHER	OREGON	PHP
4	084013000	OTHER	OREGON	BLUE CROSS HOSPICE PD
5	132204	MEDICAID	OREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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