MEDICARE: EIREEN DALE MADELO

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	171M00000X	Case Manager/Care Coordinator		OR

General Provider Information

NPI Number	:	1578490926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EIREEN DALE MADELO

Provider Business Mailing Address
First Line	:	1265 THOMAS RD
Second Line	:
City	:	MEDFORD
State	:	OR
Zip	:	97501-3865
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 W MAIN ST
Second Line	:
City	:	MEDFORD
State	:	OR
Zip	:	97501-2744
Country	:	US
Telephone Number	:	541-281-9026
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2026
Last Update Date	:	05/07/2026

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Directions to “ EIREEN DALE MADELO ” Practice Location

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