MEDICARE: RWW HOME AND COMMUNITY REHAB SERVICES OREGON, LLC

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	253Z00000X	In Home Supportive Care Agency
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1356060594
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RWW HOME AND COMMUNITY REHAB SERVICES OREGON, LLC

Provider Business Mailing Address
First Line	:	805 N WHITTINGTON PKWY
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40222-7101
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4640 S MACADAM AVE STE 80B
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97239-4256
Country	:	US
Telephone Number	:	800-320-0681
Fax Number	:	503-292-5208

Authorized Official
Title or Position	:	VICE PRESIDENT & MANAGER
Name	:	MS. MARGARET S PEMBERTON
Credential	:
Telephone Number	:	800-866-0860

Provider Enumeration Date	:	08/23/2022
Last Update Date	:	04/08/2025

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