Healthcare Provider Details

I. General information

NPI: 1831390491
Provider Name (Legal Business Name): NORTH COAST HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 12/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 9TH ST
FLORENCE OR
97439-9470
US

IV. Provider business mailing address

210 IVY AVE
TILLAMOOK OR
97141-2216
US

V. Phone/Fax

Practice location:
  • Phone: 541-997-9495
  • Fax: 541-997-2272
Mailing address:
  • Phone: 503-842-8755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: LARRY L SLAWSON
Title or Position: PRESIDENT
Credential:
Phone: 541-997-9495