Provider Demographics
NPI:1437364130
Name:TSR GROUP, INC
Entity Type:Organization
Organization Name:TSR GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:CPED
Authorized Official - Phone:503-493-3668
Mailing Address - Street 1:8225 SW APPLE WAY STE 100
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-1783
Mailing Address - Country:US
Mailing Address - Phone:503-493-3668
Mailing Address - Fax:
Practice Address - Street 1:8225 SW APPLE WAY STE 100
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-1783
Practice Address - Country:US
Practice Address - Phone:503-493-3668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR276134Medicaid
OR5039750001Medicare ID - Type Unspecified