Providence Health & Services - Oregon in Medford - Clinic/center
Providence Health & Services - Oregon - NPI 1558430314
Providence Health & Services - Oregon is a Clinic/center in Medford, Oregon. Providence Health & Services - Oregon practices all healthcare services and medical treatments related to Clinic/center. The NPI Number for Providence Health & Services - Oregon is 1558430314. The last update date is 2012-12-04.
Providence Health & Services - Oregon's current location address is 1698 E Mcandrews Rd, Medford, Oregon. You can contact this provider via phone number 5417326957 and fax number 5417327901. The mailing address for Providence Health & Services - Oregon is 1698 E Mcandrews Rd, Medford, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Providence Health & Services - Oregon |
|---|---|
| Address | 1698 E Mcandrews Rd, Medford, Oregon |
| Phone Number | 5417326957 |
| Fax Number | 5417327901 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CHIEF EXEC |
|---|---|
| Authorized Official Name | Jackson W John |
| Credentials | M.D. |
| Telephone Number | 5417326000 |
NPI Number Detail
| NPI Number | 1558430314 |
|---|---|
| Provider Enumeration Date | 2006-11-07 |
| Last Updated Date | 2012-12-04 |
Provider Mailing Address Detail
| Address | 1698 E Mcandrews Rd |
|---|---|
| City | Medford |
| State | Oregon (OR) |
| Post Code | 975045589 |
| Phone Number | 5417326957 |
| Fax Number | 5417327901 |
Provider's Primary Taxonomy Detail
| Speciality | Clinic/center |
|---|---|
| Taxonomy | 261Q00000X |
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Definition: 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 |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 500616621 | OR | DMAP | |
| CG6801 | OR | RAIL ROAD MEDICARE |
Post Comment/ Review Below
What is the unique identification code assigned to Providence Health & Services - Oregon by the Centers for Medicare & Medicaid Services?
The Providence Health & Services - Oregon has been issued the NPI (National Provider Identifier) 1558430314. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Providence Health & Services - Oregon's physical address?
The Providence Health & Services - Oregon is physically located at 1698 E Mcandrews Rd, in the city of Medford, OR, with the postal code 975045589.
What is the Providence Health & Services - Oregon's specialty and taxonomy code?
The Providence Health & Services - Oregon's specialty is Clinic/center, and the corresponding taxonomy code is 261Q00000X.
When did Providence Health & Services - Oregon receive its 1558430314 assignment?
The Providence Health & Services - Oregon was assigned its 1558430314 on 2006-11-07, which is the date when this unique identifier was issued to the organization.
As of what date was the information pertaining to Providence Health & Services - Oregon, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Providence Health & Services - Oregon, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2012-12-04.