Providence Health & Services Oregon

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PROVIDENCE HEALTH & SERVICES OREGON

Doing business as

Providence Infusion and Home Medical Equipment

Practice address

840 Royal Ave
Suite 120
Medford, OR 97504-6461

Phone

(541) 732-5566

Fax

(541) 732-5503

NPI assigned

Feb 5, 2010

Last updated

May 16, 2025By 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

Donald W Anderson Jr.

Title

Assistant Secretary Enrollment

Phone

(425) 358-9786

Specialties & licenses 3

Addresses

Other names 1

• Providence Infusion and Home Medical Equipment Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Providence Health & Services Oregon

  dba Providence Specialty Pharmacy Services-Infusion/SPP

  • Home Infusion Therapy Pharmacy
  • Portland, OR
  • NPI 1427132265

  O20210309002322

  Same enrollment

Locations

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

{
    "created_epoch": "1265328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747353600000",
    "number": "1558693291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5936 B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972285936",
            "telephone_number": "503-215-4663",
            "fax_number": "503-215-4655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 ROYAL AVE",
            "address_2": "SUITE 120",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046461",
            "telephone_number": "541-732-5566",
            "fax_number": "541-732-5503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTH & SERVICES OREGON",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-05",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY ENROLLMENT",
        "authorized_official_telephone_number": "425-358-9786",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Infusion and Home Medical Equipment",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Providence Infusion and Home Medical Equipment",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Providence Health & Services - Oregon (Providence Health Express at Medford)
• Providence Health & Services - Oregon (PMG South OB/GYN Health Center)
• Providence Health & Services Oregon (PMG South General Surgery)
• Providence Health & Services Oregon (PMG South Medford Family Practice)
• Providence Health & Services Oregon (Providence Health Sys-OR Shared Svs Div)
• Providence Health & Services Oregon (Providence Medical Group South)
• Providence Health & Services Oregon (Prov Health Sys-OR Shared-Svs Div)
• Providence Health & Services Oregon (PMG Gastroenterology)
• Providence Hospitalists & Intensivists
• Providence Medford Medical Center (Providence Medford Medical Center Lifeline)

• Durable Medical Equipment & Medical Supplies in Medford, OR
• Providers in Medford, OR by specialty
• Durable Medical Equipment & Medical Supplies in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.