Healthcare Provider Details

I. General information

NPI: 1336567585
Provider Name (Legal Business Name): PARTNERS IN CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2014
Last Update Date: 06/01/2023
Certification Date: 06/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2075 NE WYATT CT
BEND OR
97701-7686
US

IV. Provider business mailing address

2075 NE WYATT CT
BEND OR
97701-7686
US

V. Phone/Fax

Practice location:
  • Phone: 541-382-5882
  • Fax:
Mailing address:
  • Phone: 541-382-5882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number16-1031
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State

VIII. Authorized Official

Name: GREG DUANE HAGFORS
Title or Position: CEO
Credential:
Phone: 541-382-5882