MEDICARE: CSM 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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1588258925
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CSM LLC

Provider Business Mailing Address
First Line	:	18615 WILLAMETTE DR STE 100
Second Line	:
City	:	WEST LINN
State	:	OR
Zip	:	97068-1705
Country	:	US
Telephone Number	:	503-406-2256
Fax Number	:

Provider Business Practice Location Address
First Line	:	18615 WILLAMETTE DR STE 100
Second Line	:
City	:	WEST LINN
State	:	OR
Zip	:	97068-1705
Country	:	US
Telephone Number	:	503-406-2256
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MEGAN GORST
Credential	:
Telephone Number	:	503-406-2256

Provider Enumeration Date	:	02/25/2021
Last Update Date	:	04/24/2023

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