Healthcare Provider Details

I. General information

NPI: 1699482562
Provider Name (Legal Business Name): MICHELE R SAVAGE DBA GROVE MEDICAL EQUIPMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2022
Last Update Date: 11/01/2022
Certification Date: 11/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2260 NW STEWART PARKWAY
ROSEBURG OR
97471
US

IV. Provider business mailing address

2260 NW STEWART PARKWAY
ROSEBURG OR
97471
US

V. Phone/Fax

Practice location:
  • Phone: 541-225-5999
  • Fax: 541-255-4261
Mailing address:
  • Phone: 541-225-5999
  • Fax: 541-255-4261

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 Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MRS. MICHELE RENEE SAVAGE
Title or Position: OWNER
Credential:
Phone: 541-225-5999