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General NPI Number Information
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NPI Number | 1215761002
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Entity Type | Organization
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Legal Business Name | OREGON HEALTHCARE RESOURCES, LLC
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Dates
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Enumeration Date | 08/26/2024
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Last Update Date | 08/26/2024
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Provider Practice Location Address
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Address Line | 600 COUNTRY CLUB RD STE 100
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City | EUGENE
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State | OR
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Zip | 97401-2240
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Country | US
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Telephone | 541-463-2390
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Fax | 541-463-2889
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Provider Business Mailing Address
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Address Line | PO BOX 1648
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City | EUGENE
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State | OR
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Zip | 97440-1648
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Country | US
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Telephone | 541-687-4900
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Fax | 541-463-2820
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Authorized Official
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Title or Position | OWNER OF OHR PHYSICIAN GROUP, P.C.
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Name | THOMAS GLEN GRAGNOLA
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Credential | MD
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Telephone | 503-731-7518
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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