Provider Demographics
NPI:1265529747
Name:NORTH COAST HOME CARE, INC.
Entity type:Organization
Organization Name:NORTH COAST HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-842-8755
Mailing Address - Street 1:210 IVY AVE
Mailing Address - Street 2:
Mailing Address - City:TILLAMOOK
Mailing Address - State:OR
Mailing Address - Zip Code:97141-2216
Mailing Address - Country:US
Mailing Address - Phone:503-842-8755
Mailing Address - Fax:503-842-9992
Practice Address - Street 1:210 IVY AVE
Practice Address - Street 2:
Practice Address - City:TILLAMOOK
Practice Address - State:OR
Practice Address - Zip Code:97141-2216
Practice Address - Country:US
Practice Address - Phone:503-842-8755
Practice Address - Fax:503-842-9992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BC3200X, 332BP3500X, 333300000X, 332B00000X
ORNPC-0001368332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No333300000XSuppliersEmergency Response System Companies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR122887Medicaid
0232830002Medicare ID - Type UnspecifiedSECOND BRANCH
0232830001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
0232830003Medicare ID - Type UnspecifiedTHIRD BRANCH