Prov Peds Neurology Salem

LBN: Providence Health & Services - Oregon
Prov Peds Neurology Salem is an health care organization with primary practice located at 2478 13Th St Se , Salem OR 97302-2522. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Providence Health & Services - Oregon can be contacted via phone (503) 362-2481, or through Freeman, Keenan B via phone (503) 893-6524.

Contact Information

Primary practice address
2478 13Th St Se Salem OR 97302-2522
Phone: (503) 362-2481
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Freeman, Keenan B
Phone: (503) 893-6524

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X

Profile Details

NPI number 1689845489
LBN Legal business name Providence Health & Services - Oregon
DBA Doing business as Prov Peds Neurology Salem
Authorized official Freeman, Keenan B
Entity Organization
Organization subpart 1 No
Enumeration date Mar 19th, 2008
Last updated Dec 24th, 2014 - about 11 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 1689845489 NPPES
Oregon MEDICAID 279131

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