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Organization

PROVIDENCE HEALTH & SERVICES - OREGON

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

Provider details

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

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary

Other

Enumeration date
01/03/2008
Last updated
05/27/2025
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