Healthcare Provider Details

I. General information

NPI: 1790355204
Provider Name (Legal Business Name): BELLEVUE HEALTHCARE II INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2021
Last Update Date: 10/14/2024
Certification Date: 10/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1365 WILLAMETTE ST
EUGENE OR
97401-4002
US

IV. Provider business mailing address

1365 WILLAMETTE ST
EUGENE OR
97401-4002
US

V. Phone/Fax

Practice location:
  • Phone: 541-359-2471
  • Fax: 541-225-5871
Mailing address:
  • Phone: 541-359-2471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JOEL GALLION
Title or Position: PRESIDENT
Credential:
Phone: 425-451-2842