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General NPI Number Information
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NPI Number | 1629436027
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Entity Type | Organization
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Legal Business Name | FORTIS HEALTHCARE, INC.
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Dates
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Enumeration Date | 02/01/2016
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Last Update Date | 02/15/2016
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Provider Practice Location Address
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Address Line | 8002 NE HIGHWAY 99 #114
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City | VANCOUVER
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State | WA
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Zip | 98665-8876
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Country | US
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Telephone | 503-806-0855
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Fax |
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Provider Business Mailing Address
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Address Line | 8002 NE HIGHWAY 99 #114
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City | VANCOUVER
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State | WA
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Zip | 98665-8876
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATIONS OFFICER
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Name | MR. ENGELBERTO PEYNADO
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Credential |
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Telephone | 503-806-0855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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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 | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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