Provider Demographics
NPI:1295085991
Name:NIGHTINGALE HOME HEALTHCARE OF OREGON, INC.
Entity type:Organization
Organization Name:NIGHTINGALE HOME HEALTHCARE OF OREGON, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEV
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-334-7777
Mailing Address - Street 1:1036 S RANGE LINE RD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-2544
Mailing Address - Country:US
Mailing Address - Phone:317-334-7777
Mailing Address - Fax:317-569-1403
Practice Address - Street 1:2605 CROSBY AVE
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97603-5726
Practice Address - Country:US
Practice Address - Phone:541-274-6293
Practice Address - Fax:541-274-6294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health