# PROVIDENCE HEALTH & SERVICES - OREGON

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PROVIDENCE HEALTH & SERVICES - OREGON
- **Other names:** Providence Medford Medical Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1518142074
- **Legal business name:** PROVIDENCE HEALTH & SERVICES - OREGON
- **Authorized official:** DONALD W ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENTS)
- **Authorized official phone:** (425) 358-9786

## Contact information

- **Practice address:** 1111 CRATER LAKE AVE, MEDFORD, OR 97504-6241
- **Practice address phone:** (541) 732-5079
- **Practice address fax:** (541) 732-5859
- **Mailing address:** PO BOX 31001-4199, PASADENA, CA 91110-4199
- **Mailing address phone:** (907) 312-7903
- **Mailing address fax:** (425) 276-3215

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 01/03/2008
- **Last updated:** 05/27/2025