Providence Medford Medical Center Lifeline
LBN: Providence Medford Medical Center
Providence Medford Medical Center Lifeline is an health care organization with primary practice located at 1111 Crater Lake Avenue , Medford OR 97504-6214. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Emergency Care, Hospitals / General Acute Care Hospital. Ambulatory Health Care Facilities / Emergency Care is the primary health care specialty.
Providence Medford Medical Center can be contacted via phone (541) 732-5000, or through Hanenburg, Thomas E via phone (541) 732-5050.
Contact Information
Primary practice address
1111 Crater Lake Avenue
Medford OR 97504-6214
Phone: (541) 732-5000
Fax: (541) 732-5131
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Emergency Care | 261QE0002X | Oregon | |
| Hospitals / General Acute Care Hospital | 282N00000X | 140734 | Oregon |
Profile Details
| NPI number | 1013944776 |
|---|---|
| LBN Legal business name | Providence Medford Medical Center |
| DBA Doing business as | Providence Medford Medical Center Lifeline |
| Authorized official | Hanenburg, Thomas E |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 27th, 2006 |
| Last updated | Sep 8th, 2008 - about 16 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 | 1013944776 | NPPES |
| Oregon | MEDICAID | 227950 |
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