Pmg South Ob/Gyn Health Center

LBN: Providence Health & Services - Oregon
Pmg South Ob/Gyn Health Center is an health care organization with primary practice located at 940 Royal Ave Suite 350, Medford OR 97504-6193. 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 (541) 732-7460, or through Jackson, John W via phone (541) 732-6000.

Contact Information

Primary practice address
940 Royal Ave Suite 350 Medford OR 97504-6193
Phone: (541) 732-7460
Fax: (541) 732-7461
Website:
Map and Directions
Authorized official contact:
Name: Jackson, John W Doctor of Medicine (MD)
Phone: (541) 732-6000

Health care specialties

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

Profile Details

NPI number 1982781696
LBN Legal business name Providence Health & Services - Oregon
DBA Doing business as Pmg South Ob/Gyn Health Center
Authorized official Jackson, John W Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 Yes
Enumeration date Nov 1st, 2006
Last updated Oct 12th, 2011 - about 14 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 1982781696 NPPES
Oregon MEDICAID 022825
Oregon Other CG6801

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