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SISTERS OF PROVIDENCE IN OREGON NPI 1134206790


NPI Information

NPI: 1134206790
Provider Name: SISTERS OF PROVIDENCE IN OREGON

Doing Business As: PMG SOUTH JACKSONVILLE

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
725 N 5TH ST
SUITE 101
JACKSONVILLE, OR
ZIP 97530
Phone: (541) 899-8686
Get Directions

SISTERS OF PROVIDENCE IN OREGON is a clinic center in Jacksonville, OR. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). SISTERS OF PROVIDENCE IN OREGON NPI is 1134206790. The provider is registered as an organization entity type.
The provider Is Doing Business As Pmg South Jacksonville.

The provider's business location address is:

725 N 5TH ST
SUITE 101
JACKSONVILLE, OR
ZIP 97530-873
Phone: (541) 899-8686

The provider's authorized official is John Jackson .
The authorized official title is Chief Executive Officer and has the following contact phone number (541) 732-6000.

The enumeration date for this NPI number is 11/1/2006 and was last updated on 4/11/2008.


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
1261Q00000XClinic/CenterYes

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
1022823MEDICAIDOREGON
2R105969MEDICARE PINOREGON
3CG6801OTHEROREGONRAIL ROAD NUMBER

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.