Healthcare Provider Details

I. General information

NPI: 1487593893
Provider Name (Legal Business Name): PAINTED HILLS MEDICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2026
Last Update Date: 03/28/2026
Certification Date: 03/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40543 S TWICKENHAM RD
MITCHELL OR
97750-9407
US

IV. Provider business mailing address

40543 S TWICKENHAM RD
MITCHELL OR
97750-9407
US

V. Phone/Fax

Practice location:
  • Phone: 208-407-6696
  • Fax: 541-462-3165
Mailing address:
  • Phone: 208-407-6696
  • Fax: 541-462-3165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: STEVEN PATRICK HOLLY
Title or Position: OWNER
Credential:
Phone: 208-407-6696