Provider Demographics
NPI:1629436027
Name:FORTIS HEALTHCARE, INC.
Entity Type:Organization
Organization Name:FORTIS HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ENGELBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:PEYNADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-806-0855
Mailing Address - Street 1:8002 NE HIGHWAY 99
Mailing Address - Street 2:#114
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-8876
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8002 NE HIGHWAY 99
Practice Address - Street 2:#114
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-8876
Practice Address - Country:US
Practice Address - Phone:503-806-0855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-01
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No251E00000XAgenciesHome Health