Healthcare Provider Details

I. General information

NPI: 1215761002
Provider Name (Legal Business Name): OREGON HEALTHCARE RESOURCES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2024
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 COUNTRY CLUB RD STE 100
EUGENE OR
97401-2240
US

IV. Provider business mailing address

PO BOX 1648
EUGENE OR
97440-1648
US

V. Phone/Fax

Practice location:
  • Phone: 541-463-2390
  • Fax: 541-463-2889
Mailing address:
  • Phone: 541-687-4900
  • Fax: 541-463-2820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: THOMAS GLEN GRAGNOLA
Title or Position: OWNER OF OHR PHYSICIAN GROUP, P.C.
Credential: MD
Phone: 503-731-7518