Organization
PEACEHEALTH MEDICAL GROUP
Active
Other names
SOUTH CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY APLAND (CFO)
(541) 686-3968
Entity
Organization
Contact information
Practice address
3299 HILYARD ST, EUGENE, OR 97405-3721
(541) 687-6016
Mailing address
PO BOX 24410, EUGENE, OR 97402-0451
(541) 349-7683
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1042230005
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
071634
—
OR
01
—
1042230005
DME LICENSE NUMBER
OR
Enumeration date
08/19/2006
Last updated
01/15/2009
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