# GRANDE RONDE HOSPITAL HOME OXYGEN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629008479
- **Authorized official:** MR. JAMES MATTES (PRESIDENT CEO)
- **Authorized official phone:** (541) 963-1469

## Contact information

- **Practice address:** 900 SUNSET DR, LA GRANDE, OR 97850-1362
- **Practice address phone:** (541) 963-8421
- **Mailing address:** PO BOX 3290, LA GRANDE, OR 97850-7290
- **Mailing address phone:** (541) 963-8421

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | — | NULL | Yes |

## Other

- **Enumeration date:** 07/04/2006
- **Last updated:** 08/22/2020