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NPI Code Detail

MEDICARE: PREMISE HEALTH OF OREGON MEDICAL PC

MEDICARE: PREMISE HEALTH OF OREGON MEDICAL PC
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
1261QM1300XMulti-Specialty Clinic/Center

General Provider Information

NPI Number : 1891450003
Entity Type Code : Organization
Provider Name (Legal Business Name) : PREMISE HEALTH OF OREGON MEDICAL PC
Provider Business Mailing Address
First Line : 5500 MARYLAND WAY STE 120
Second Line :
City : BRENTWOOD
State : TN
Zip : 37027-4993
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 63360 BRITTA ST STE 1
Second Line :
City : BEND
State : OR
Zip : 97703-9475
Country : US
Telephone Number : 541-322-7639
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : EDWARD WILLIAM SCHWARTZ
Credential :
Telephone Number : 844-407-7557
Provider Enumeration Date : 11/02/2021
Last Update Date : 02/05/2026

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Directions to “PREMISE HEALTH OF OREGON MEDICAL PC ” Practice Location

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