Peacehealth

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

N/A

Legal business name

PEACEHEALTH

Doing business as

Peace Harbor Hospice

Practice address

2230 Kingwood Street
Florence, OR 97439-9470

Phone

(541) 997-3418

Fax

(541) 902-6740

NPI assigned

Nov 10, 2005

Last updated

Aug 20, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Richard Yecny

Title

Ceo

Phone

(541) 902-6050

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Peace Harbor Hospice Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Peacehealth

  dba PeaceHealth Home Health of Whatcom County

  • Home Health Agency
  • Bellingham, WA
  • NPI 1710639901

  Member Of

  NPD member

Locations

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Peacehealth

  dba Sacred Heart Hospice

  • Community Based Hospice Care Agency
  • Springfield, OR
  • NPI 1073594065

  Sold to, 2019-04-01

  CMS change of ownership

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408492800000",
    "number": "1215918719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 9TH STREET",
            "city": "FLORENCE",
            "state": "OR",
            "postal_code": "974399470",
            "telephone_number": "541-997-3418",
            "fax_number": "541-902-6740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 KINGWOOD STREET",
            "city": "FLORENCE",
            "state": "OR",
            "postal_code": "974399470",
            "telephone_number": "541-997-3418",
            "fax_number": "541-902-6740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACEHEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-10",
        "last_updated": "2014-08-20",
        "status": "A",
        "authorized_official_last_name": "YECNY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-902-6050",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": "N/A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135884",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peace Harbor Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Malena Marie Ortega
• Gregory Eugene Page, D.C.
• David Y Park, M.D.
• Justine E Parker, D.O.
• Deborah Lynn Pasternak, LMT
• Peacehealth (Peace Harbor Home Health)
• Peacehealth (Peace Harbor Medical Center)
• Peacehealth (Peace Harbor Medical Center)
• Peacehealth (Peace Harbor Medical Center)
• Paul E. Pearson, M.D.

• Community Based Hospice Care Agency in Florence, OR
• Providers in Florence, OR by specialty
• Community Based Hospice Care Agency in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.