Provider Demographics
NPI:1134540933
Name:ANCILLARY RESOURCES
Entity type:Organization
Organization Name:ANCILLARY RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DODIE
Authorized Official - Middle Name:RACHEL
Authorized Official - Last Name:NOLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-944-1247
Mailing Address - Street 1:302 E HERSEY ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-1200
Mailing Address - Country:US
Mailing Address - Phone:541-944-1247
Mailing Address - Fax:541-488-5885
Practice Address - Street 1:302 E HERSEY ST
Practice Address - Street 2:SUITE 1
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1200
Practice Address - Country:US
Practice Address - Phone:541-944-1247
Practice Address - Fax:541-488-5885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-20
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty