Healthcare Provider Details

I. General information

NPI: 1073610358
Provider Name (Legal Business Name): HOME PARENTERAL CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 04/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S BERTELSEN RD SUITE 4
EUGENE OR
97402-5434
US

IV. Provider business mailing address

1000 S BERTELSEN RD SUITE 4
EUGENE OR
97402-5434
US

V. Phone/Fax

Practice location:
  • Phone: 541-683-3700
  • Fax: 541-683-3415
Mailing address:
  • Phone: 541-683-3700
  • Fax: 541-683-3415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License NumberRP0000862CS
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License NumberRP0000862CS
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number StateOR
# 4
Primary TaxonomyY
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number StateOR

VII. Legacy identifiers

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

# 1
Identifier243170
Identifier TypeMEDICAID
Identifier StateOR
Identifier Issuer
# 2
Identifier269104
Identifier TypeMEDICAID
Identifier StateOR
Identifier Issuer

VIII. Authorized Official

Name: MR. RICHARD J REEDAL
Title or Position: PRESIDENT
Credential: RPH
Phone: 541-683-3700