Organization
ASHLAND MEDICAL SERVICES, INC
Active
Other names
so. ore. medical equipment
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEPHEN WYATT CROY (OWNER)
(541) 324-3880
Entity
Organization
Contact information
Practice address
1600 E BARNETT RD, MEDFORD, OR 97504-8283
(541) 773-5994
(541) 773-6015
Mailing address
2305 ASHLAND ST, PMB 448, ASHLAND, OR 97520-3777
(541) 773-5994
(541) 773-6015
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
07-00028954
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006035
—
OR
01
—
200409101
REGENCE BC/BS PC 65 #
OR
01
—
872666000
REGENCE BC/BS PPP/PC #
OR
Enumeration date
10/04/2006
Last updated
11/01/2017
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