Provider Demographics
NPI:1508155425
Name:OREGON HEALTHCARE RESOURCES LLC
Entity Type:Organization
Organization Name:OREGON HEALTHCARE RESOURCES LLC
Other - Org Name:OREGON MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPPORT SERVICES MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHETER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-687-4900
Mailing Address - Street 1:PO BOX 1648
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97440-1648
Mailing Address - Country:US
Mailing Address - Phone:541-687-4900
Mailing Address - Fax:541-687-4904
Practice Address - Street 1:1835 PEARL ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-8217
Practice Address - Country:US
Practice Address - Phone:541-687-1668
Practice Address - Fax:541-684-3061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-31
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR6501380005OtherDME PTAN