Provider Demographics
NPI:1164590287
Name:OREGON HEALTH & SCIENCE UNIVERSITY
Entity Type:Organization
Organization Name:OREGON HEALTH & SCIENCE UNIVERSITY
Other - Org Name:EOU STUDENT HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:F
Authorized Official - Last Name:GRUBBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-962-3524
Mailing Address - Street 1:1 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:LA GRANDE
Mailing Address - State:OR
Mailing Address - Zip Code:97850-2807
Mailing Address - Country:US
Mailing Address - Phone:541-962-3524
Mailing Address - Fax:541-962-3825
Practice Address - Street 1:1 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:LA GRANDE
Practice Address - State:OR
Practice Address - Zip Code:97850-2807
Practice Address - Country:US
Practice Address - Phone:541-962-3524
Practice Address - Fax:541-962-3825
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OREGON HEALTH & SCIENCE UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-30
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health