MEDICARE: PNW HOME CARE, 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

General Provider Information

NPI Number	:	1699520296
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PNW HOME CARE, LLC

Provider Business Mailing Address
First Line	:	2195 NE PROFESSIONAL CT STE 15
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97701-6028
Country	:	US
Telephone Number	:	541-510-1877
Fax Number	:

Provider Business Practice Location Address
First Line	:	2195 NE PROFESSIONAL CT STE 15
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97701-6028
Country	:	US
Telephone Number	:	541-510-1877
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANDREW MOSMAN
Credential	:
Telephone Number	:	541-633-7436

Provider Enumeration Date	:	04/18/2024
Last Update Date	:	04/18/2024

Similar Medicare Providers

1225831837 — NEIGHBORHOOD FAMILY MEDICINE
Practice Location Address:

2195 NE PROFESSIONAL CT
BEND, OR
97701-6028

Practice Phone: 541-322-9396
Practice Fax:

1235165325 — BRADLEY JOHN BURKET D.M.D.,M.D.
Practice Location Address:

2195 NE PROFESSIONAL CT , STE 1
BEND, OR
97701-6028

Practice Phone: 541-322-9396
Practice Fax: 541-322-9398

1821225103 — WELLBODY THERAPEUTICS, LLC
Practice Location Address:

2195 NE PROFESSIONAL CT , SUITE # 6
BEND, OR
97701-6028

Practice Phone: 541-390-4361
Practice Fax: 541-322-9398

1538579727 — QHSA DBA DR. BRADLEY J BURKET DMD, MD
Practice Location Address:

2195 NE PROFESSIONAL CT STE 1
BEND, OR
97701-6028

Practice Phone: 541-322-9396
Practice Fax: 541-322-9398

1215301163 — CASCADE IN HOME CARE, LLC
Practice Location Address:

2195 NE PROFESSIONAL CT
BEND, OR
97701-6028

Practice Phone: 541-633-7436
Practice Fax: 541-633-7438

1780249193 — ASHLEIGH FORD PA-C
Practice Location Address:

2195 NE PROFESSIONAL CT STE 1
BEND, OR
97701-6028

Practice Phone: 541-322-9396
Practice Fax: 541-322-9398

Directions to “PNW HOME CARE, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.