Organization
ST. CHARLES HEALTH SYSTEM, INC.
Active
Other names
ST. CHARLES ANTI-COAG CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN M SHEPARD (SR VP FINANCE / CFO)
(541) 706-7707
Entity
Organization
Contact information
Practice address
2100 NE WYATT CT, SUITE 103, BEND, OR 97701-7702
(541) 706-4701
(541) 706-4751
Mailing address
PO BOX 1420, REDMOND, OR 97756-0400
(541) 526-6556
(541) 706-3765
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500625168
—
OR
Enumeration date
01/04/2011
Last updated
01/04/2011
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