Provider Demographics
NPI:1356073654
Name:BENCO
Entity Type:Organization
Organization Name:BENCO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:FRAZZINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-753-5040
Mailing Address - Street 1:165 NE CONIFER BLVD
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-4105
Mailing Address - Country:US
Mailing Address - Phone:541-753-5040
Mailing Address - Fax:
Practice Address - Street 1:165 NE CONIFER BLVD
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-4105
Practice Address - Country:US
Practice Address - Phone:541-753-5040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care