History Makers, Inc.

Organization Active NPI Home Health Agency · Roseburg, OR

NPI 1679908628 · NPPES record last updated Sep 10, 2013

Key facts

NPI
1679908628
Entity type
Organization (NPI type 2)
Primary specialty
Home Health Agency 251E00000X
License
15-2204 (OR)
Legal business name
HISTORY MAKERS, INC.
Practice address
220 Cinbar Dr
Roseburg, OR 97471-9385
Phone
(541) 229-5263
Fax
(541) 229-5265
NPI assigned
Sep 10, 2013
Organization subpart
No

Authorized official

Name
Mrs. Carol Frances Brooker-Gardner, RN
Title
Administrator
Phone
(541) 229-5263

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
History Makers Inc (3 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 15-2204 OR Yes

Addresses

Primary practice location

220 Cinbar Dr
Roseburg, OR 97471-9385

Mailing address

220 Cinbar Dr
Roseburg, OR 97471-9385
Phone (541) 229-5263

Other identifiers

IdentifierTypeStateIssuer
521319MedicaidOR

Other providers in Roseburg, OR

All providers in Roseburg, OR · Home Health Agency in Oregon

Sources for this page

Verify at the official NPI Registry.