Provider Demographics
NPI:1740379973
Name:TOUCHMARK ON SOUTH HILL LP
Entity Type:Organization
Organization Name:TOUCHMARK ON SOUTH HILL LP
Other - Org Name:TOUCHMARK ON SOUTH HILL HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:PRYOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-646-5186
Mailing Address - Street 1:5150 SW GRIFFITH DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-2935
Mailing Address - Country:US
Mailing Address - Phone:503-646-5186
Mailing Address - Fax:503-644-3568
Practice Address - Street 1:2929 S WATERFORD DR
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-4400
Practice Address - Country:US
Practice Address - Phone:509-536-2929
Practice Address - Fax:509-536-3999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAIS-071251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAIHS.FS.00000071OtherSTATE OF WA LICENSE