Provider Demographics
NPI:1831390491
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:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SLAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-997-9495
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:
Practice Address - Street 1:320 9TH ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:OR
Practice Address - Zip Code:97439-9470
Practice Address - Country:US
Practice Address - Phone:541-997-9495
Practice Address - Fax:541-997-2272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR0232830003Medicare ID - Type Unspecified