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General NPI Number Information
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NPI Number | 1821488891
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Entity Type | Organization
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Legal Business Name | PEACEHEALTH MEDICAL GROUP
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Dates
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Enumeration Date | 01/29/2015
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Last Update Date | 01/29/2015
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Provider Practice Location Address
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Address Line | 860 BELTLINE RD
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City | SPRINGFIELD
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State | OR
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Zip | 97477-1091
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Country | US
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Telephone | 541-222-6005
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Fax | 541-222-6030
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Provider Business Mailing Address
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Address Line | PO BOX 24410
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City | EUGENE
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State | OR
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Zip | 97402-0451
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Country | US
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Telephone | 541-685-1982
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | WENDY APLAND
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Credential |
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Telephone | 541-222-2007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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