Provider Demographics
NPI:1255730743
Name:MCMINNVILLE HOME HEALTH LLC
Entity type:Organization
Organization Name:MCMINNVILLE HOME HEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-757-2700
Mailing Address - Street 1:2365 NORTHSIDE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-2720
Mailing Address - Country:US
Mailing Address - Phone:888-871-0766
Mailing Address - Fax:866-551-0846
Practice Address - Street 1:2601 25TH ST SE STE 340
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-1391
Practice Address - Country:US
Practice Address - Phone:503-766-3124
Practice Address - Fax:503-575-9767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-20
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR387108Medicare Oscar/Certification