National Provider Identifier Database

PROVIDENCE HEALTH SERVICES OREGON
Hospice Care, Community Based


Contact Information

PROVIDENCE HEALTH & SERVICES OREGON
2033 COMMERCE DR
MEDFORD, OR97504-9744
Phone: 541-732-6500
Fax:
Website:
Specialty Taxonomy Code
* Hospice Care, Community Based 251G00000X

* Indicates primary specialty

NPI Profile & details for PROVIDENCE HEALTH & SERVICES OREGON

NPI Number 1952495772
Legal business name
LBN
PROVIDENCE HEALTH & SERVICES OREGON
Authorized official DONALD ANDERSON - (ASSISTANT SECRETARY ENROLLMENT)
Entity Organization
Organization subpart No
Enumeration date 10/03/2006
Last updated 05/16/2025 - More than a year ago
Sole proprietor1 Not specified
Identifiers
  • OR Medicaid: 132204
  • OR Other: 026699000 BLUE CROSS FFS
  • OR Other: 084013000 BLUE CROSS HOSPICE PD
  • OR Other: 930386912-03 ODS
  • OR Other: 303804000001 PHP

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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