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NPI Code Detail

MEDICARE: SOUTH COAST HOSPICE & PALLIATIVE CARE SERVICES INC

MEDICARE: SOUTH COAST HOSPICE & PALLIATIVE CARE SERVICES 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
1251G00000XCommunity Based Hospice Care Agency1986-005OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
155693000OTHERORBLUE CROSS PROVIDER #
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3J3986-01OTHERORPACIFIC SOURCE PROVIDER #

General Provider Information

NPI Number : 1417956558
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTH COAST HOSPICE & PALLIATIVE CARE SERVICES INC
Provider Business Mailing Address
First Line : 1620 THOMPSON RD
Second Line :
City : COOS BAY
State : OR
Zip : 97420-2150
Country : US
Telephone Number : 541-269-2986
Fax Number : 541-269-0576
Provider Business Practice Location Address
First Line : 1620 THOMPSON RD
Second Line :
City : COOS BAY
State : OR
Zip : 97420-2150
Country : US
Telephone Number : 541-269-2986
Fax Number : 541-269-0576
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MS. LORELL DURKEE
Credential :
Telephone Number : 541-269-2986
Provider Enumeration Date : 07/20/2005
Last Update Date : 03/30/2021

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Directions to “SOUTH COAST HOSPICE & PALLIATIVE CARE SERVICES INC ” Practice Location

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