Healthcare Provider Details

I. General information

NPI: 1447433172
Provider Name (Legal Business Name): ST. CHARLES HEALTH SYSTEM, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2007
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2275 NE DOCTORS DR STE 5
BEND OR
97701-6324
US

IV. Provider business mailing address

2500 NE NEFF RD
BEND OR
97701-6015
US

V. Phone/Fax

Practice location:
  • Phone: 541-706-7796
  • Fax: 541-706-5996
Mailing address:
  • Phone: 541-706-7796
  • Fax: 541-706-5996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number13140239
License Number StateOR

VIII. Authorized Official

Name: MATTHEW R SWAFFORD
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 541-382-4321