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General NPI Number Information
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NPI Number | 1508677758
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Entity Type | Organization
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Legal Business Name | ST. CHARLES HEALTH SYSTEM, INC.
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Dates
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Enumeration Date | 01/16/2025
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 333 NW LARCH AVE STE 110
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City | REDMOND
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State | OR
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Zip | 97756-1186
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Country | US
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Telephone | 541-382-3344
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Fax | 541-382-1681
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Provider Business Mailing Address
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Address Line | PO BOX 6095
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City | BEND
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State | OR
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Zip | 97708-6095
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Country | US
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Telephone | 541-382-4321
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MATTHEW SWAFFORD
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Credential |
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Telephone | 541-382-4321
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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