Healthcare Provider Details

I. General information

NPI: 1699396267
Provider Name (Legal Business Name): OREGON HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2020
Last Update Date: 05/05/2020
Certification Date: 05/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

354 N MAIN ST
OREGON WI
53575-1426
US

IV. Provider business mailing address

801 BROAD ST STE 300
CHATTANOOGA TN
37402-2668
US

V. Phone/Fax

Practice location:
  • Phone: 608-835-3535
  • Fax: 608-835-3890
Mailing address:
  • Phone: 423-424-1859
  • Fax: 423-308-1844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. CRAIG D TAYLOR
Title or Position: PRESIDENT, OREGON HEALTHCARE LLC
Credential:
Phone: 423-308-1845