Healthcare Provider Details

I. General information

NPI: 1649873688
Provider Name (Legal Business Name): GEORGE FRANCIS GREGORY CPO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2020
Last Update Date: 11/20/2020
Certification Date: 11/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3355 CHAD DR
EUGENE OR
97408-7428
US

IV. Provider business mailing address

7465 KINGS VALLEY HWY
MONMOUTH OR
97361-9555
US

V. Phone/Fax

Practice location:
  • Phone: 541-607-0897
  • Fax:
Mailing address:
  • Phone: 541-821-0529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (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:
Title or Position:
Credential:
Phone: