Pmg South Medford Pediatrics
LBN: Providence Health & Services - Oregon
Pmg South Medford Pediatrics is an health care organization with primary practice located at 840 Royal Ave Suite 110, Medford OR 97504-6461. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, Ambulatory Health Care Facilities / Clinic/Center, Ambulatory Health Care Facilities / Adolescent and Children Mental Health. Ambulatory Health Care Facilities / Clinic/Center is the primary health care specialty.
Providence Health & Services - Oregon can be contacted via phone (541) 732-8370, or through Anderson, Donald W via phone (425) 525-5392.
Contact Information
Primary practice address
840 Royal Ave Suite 110
Medford OR 97504-6461
Phone: (541) 732-8370
Fax: (541) 732-8371
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | ||
Ambulatory Health Care Facilities / Clinic/Center | 261Q00000X | ||
Ambulatory Health Care Facilities / Adolescent and Children Mental Health | 261QM0855X |
Profile Details
NPI number | 1316024128 |
---|---|
LBN Legal business name | Providence Health & Services - Oregon |
DBA Doing business as | Pmg South Medford Pediatrics |
Authorized official | Anderson, Donald W DIR REIMB REG STRAT/ |
Entity | Organization |
Organization subpart 1 | Yes |
Enumeration date | Nov 1st, 2006 |
Last updated | Jun 15th, 2021 - about 3 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1316024128 | NPPES |
Oregon | Other | CG6801 | RAIL ROAD MEDICARE |
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