Healthcare Provider Details

I. General information

NPI: 1588362016
Provider Name (Legal Business Name): HEMSLEY HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2023
Last Update Date: 05/28/2023
Certification Date: 05/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

498 HARLOW RD STE 5
SPRINGFIELD OR
97477-1339
US

IV. Provider business mailing address

498 HARLOW RD STE 5
SPRINGFIELD OR
97477-1339
US

V. Phone/Fax

Practice location:
  • Phone: 541-681-8446
  • Fax:
Mailing address:
  • Phone: 541-681-8446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GREGORY BARTON HEMSLEY
Title or Position: OWNER
Credential: MD
Phone: 541-681-8446