Healthcare Provider Details

I. General information

NPI: 1083547277
Provider Name (Legal Business Name): NEXPHASE TELEHEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 NW OUTLOOK VISTA DR
BEND OR
97703-5473
US

IV. Provider business mailing address

221 NW OUTLOOK VISTA DR
BEND OR
97703-5473
US

V. Phone/Fax

Practice location:
  • Phone: 330-635-7750
  • Fax:
Mailing address:
  • Phone: 801-390-3140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DEVIN BRIMHALL
Title or Position: CO-OWNER
Credential: PHARM D
Phone: 330-635-7750