Healthcare Provider Details

I. General information

NPI: 1063458313
Provider Name (Legal Business Name): ASANTE HEALTH SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 02/24/2020
Certification Date: 02/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 E. BARNETT RD. STE. 1
MEDFORD OR
97504-8380
US

IV. Provider business mailing address

2900 E. BARNETT RD. STE. 1
MEDFORD OR
97504-8380
US

V. Phone/Fax

Practice location:
  • Phone: 541-789-5850
  • Fax: 541-789-3904
Mailing address:
  • Phone: 541-789-5850
  • Fax: 541-789-3904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number01330
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: AMY R WATSON
Title or Position: MANAGER
Credential: PHARMD
Phone: 541-789-5031