Provider Demographics
NPI:1649873688
Name:GREGORY, GEORGE FRANCIS (CPO)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:FRANCIS
Last Name:GREGORY
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7465 KINGS VALLEY HWY
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH
Mailing Address - State:OR
Mailing Address - Zip Code:97361-9555
Mailing Address - Country:US
Mailing Address - Phone:541-821-0529
Mailing Address - Fax:
Practice Address - Street 1:3355 CHAD DR
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97408-7428
Practice Address - Country:US
Practice Address - Phone:541-607-0897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment