MEDICARE: ST. CHARLES HEALTH SYSTEM, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	14-1457	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4700002	OTHER	OR	CLEAR CHOICE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	400072	OTHER	OR	COIHS
4	239482000001	OTHER	OR	PROVIDENCE HEALTH PLAN
5	081408000	OTHER	OR	BLUE CROSS OF OREGON
6	P328701	OTHER	OR	PACIFICSOURCE HEALTH PLAN

General Provider Information

NPI Number	:	1144215542
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST. CHARLES HEALTH SYSTEM, INC.

Provider Business Mailing Address
First Line	:	PO BOX 6095
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97708-6095
Country	:	US
Telephone Number	:	541-382-4321
Fax Number	:

Provider Business Practice Location Address
First Line	:	2275 NE DOCTORS DR STE 4
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97701-6324
Country	:	US
Telephone Number	:	541-706-7796
Fax Number	:	541-706-4996

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MATTHEW R SWAFFORD
Credential	:
Telephone Number	:	541-382-4321

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	02/23/2026

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Directions to “ST. CHARLES HEALTH SYSTEM, INC. ” Practice Location

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