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
Fax: (541) 732-8371
Website:
Authorized official contact:
Name: Anderson, Donald W DIR REIMB REG STRAT/

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316024128 NPPES
Oregon Other CG6801 RAIL ROAD MEDICARE

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