| Providence Health & Services - Oregon | |
|
70 Bower Dr Medford OR 97501-3689 | |
| (541) 734-3430 | |
| (541) 734-3638 |
| Full Name | Providence Health & Services - Oregon |
|---|---|
| Speciality | Clinic/center |
| Location | 70 Bower Dr, Medford, Oregon |
| Authorized Official Name and Position | Donald Wayne Anderson (ASSISTANT SECRETARY - ENROLLMENT) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Health & Services - Oregon Po Box 3158 Portland OR 97208-3158 Ph: (541) 734-3430 | Providence Health & Services - Oregon 70 Bower Dr Medford OR 97501-3689 Ph: (541) 734-3430 |
| NPI Number | 1346619467 |
|---|---|
| Provider Enumeration Date | 09/18/2015 |
| Last Update Date | 01/16/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346619467 | NPI | - | NPPES |
| 500692938 | Medicaid | OR |
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