Provider Demographics
NPI:1720299258
Name:EUGENE HAND THERAPY CLINIC LLC
Entity Type:Organization
Organization Name:EUGENE HAND THERAPY CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:AHEARN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:541-688-9595
Mailing Address - Street 1:PO BOX 50056
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-0967
Mailing Address - Country:US
Mailing Address - Phone:541-688-9595
Mailing Address - Fax:541-688-9595
Practice Address - Street 1:2866 CRESCENT AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97408-7342
Practice Address - Country:US
Practice Address - Phone:541-688-9595
Practice Address - Fax:541-688-1818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR988571332B00000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
121557Medicare UPIN