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Organization

AT HOME PRIMARY CARE

Active
Parent organization
HOUSECALL MEDICAL SERVICES INC
Other names
Housecall Medical Services Inc
Organization subpart
Yes

Provider details

NPI number
Legal business name
HOUSECALL MEDICAL SERVICES INC
Authorized official
MONICA FERGUSON NP (CEO)
(503) 358-7908
Entity
Organization

Contact information

Practice address
511 MAIN ST, SUITE 112, OREGON CITY, OR 97045-1830
(503) 344-6717
(503) 345-9867
Mailing address
PO BOX 945, LAKE OSWEGO, OR 97034-0103
(503) 344-6717
(503) 345-9867

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
200650008NP
OR
363LP2300X
Primary Care Nurse Practitioner
200650008NP
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1093053431
NPI GROUP HMS
OR
01
1932154366
NPI INDIV
OR
01
200650008NP
NP LICENSE
OR
05
243056
OR
05
500678021
OR
01
R178969
MEDICARE ID INDIV
OR
01
R178970
MEDICARE ID GROUP
OR
Enumeration date
05/20/2016
Last updated
05/20/2016
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