Pmg South Eagle Point
LBN: Providence Health & Services - Oregon
Pmg South Eagle Point is an health care organization with primary practice located at 1332 S Shasta Ave Suite A, Eagle Point OR 97524-8623. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, Allopathic & Osteopathic Physicians / Geriatric Psychiatry, Ambulatory Health Care Facilities / Multi-Specialty. Ambulatory Health Care Facilities / Multi-Specialty is the primary health care specialty.
Providence Health & Services - Oregon can be contacted via phone (541) 826-8160, or through Anderson, Donald W via phone (425) 525-5392.
Contact Information
Primary practice address
1332 S Shasta Ave Suite A
Eagle Point OR 97524-8623
Phone: (541) 826-8160
Fax: (541) 826-8197
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | ||
| Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | ||
| Allopathic & Osteopathic Physicians / Geriatric Psychiatry | 2084P0805X | ||
| Ambulatory Health Care Facilities / Multi-Specialty | 261QM1300X |
Profile Details
| NPI number | 1992031595 |
|---|---|
| LBN Legal business name | Providence Health & Services - Oregon |
| DBA Doing business as | Pmg South Eagle Point |
| Authorized official | Anderson, Donald W |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Nov 2nd, 2009 |
| Last updated | Aug 12th, 2020 - about 4 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 | 1992031595 | NPPES |
| Oregon | MEDICAID | 500617058 |
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