Organization
GRANDE RONDE HOSPITAL HOME OXYGEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES MATTES (PRESIDENT CEO)
(541) 963-1469
Entity
Organization
Contact information
Practice address
900 SUNSET DR, LA GRANDE, OR 97850-1362
(541) 963-8421
Mailing address
PO BOX 3290, LA GRANDE, OR 97850-7290
(541) 963-8421
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139357
—
OR
Enumeration date
07/04/2006
Last updated
08/22/2020
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