NPIMap

Organization Active NPI

Pacific Home Care Associates Inc.

Doing business as Pacific Home Health & Hospice

  • Home Health Agency
  • Coos Bay, OR
National Provider Identifier
1851350086
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PACIFIC HOME CARE ASSOCIATES INC.
Doing business as
Pacific Home Health & Hospice
Practice address
375 Park Ave Ste 6
Coos Bay, OR 97420-2242
Phone
(541) 266-7005
NPI assigned
Mar 17, 2006
Last updated
Jan 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Authorized official

Name
Donald Freeman
Title
President
Phone
(405) 878-0202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

375 Park Ave Ste 6
Coos Bay, OR 97420-2242

Mailing address

120 W Macarthur St Ste 121
Shawnee, OK 74804-2005
Phone (405) 878-0202

Other identifiers 1

IdentifierTypeStateIssuer
137518MedicaidOR

Other names 1

  • Pacific Home Health & Hospice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060425000344 OR Part A Provider - Home Health Agency 3971513722 Practice locations: Coos Bay, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1851350086. Details of each certification follow.

Home health agency certification: CCN 387135

Legal name
PACIFIC HOME CARE ASSOCIATES, INC.
Doing business as
PACIFIC HOME HEALTH & HOSPICE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 13, 1996
Last certification
Mar 13, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jul 12, 1996 in OR
Enrollment address
375 Park Ave
Ste 6
Coos Bay, OR 97420-2242

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Pacific Home Health and HospiceCCN 387135 · All quality measures
Overall star rating
2 of 5
Ownership
Proprietary
Certified
Aug 13, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Speech pathology

National Provider Directory

National Provider Directory
Tax ID family
Pacific Home Care Associates4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

375 Park Ave
Ste 6
Coos Bay, OR 97420
Phone (541) 266-7005

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Donald a Freeman Individual 5% Or Greater Direct Ownership InterestPresident Sep 30, 2009 100%
Corporate OfficerPresident Sep 30, 2009
Corporate DirectorPresident Sep 30, 2009
Troy a Cribbins Individual W-2 Managing EmployeeInterim Administrator Jan 14, 2019
Preferred Management Corporation Organization, Shawnee, OK Corporation Operational/Managerial Control Sep 30, 2009
Luke Campbell Individual Corporate OfficerVP of Finance Feb 1, 2025
Jared Chanski Individual Corporate OfficerExecutive Vice President Jan 1, 2019
Josh Tucker Individual Corporate OfficerChief Financial Officer Jan 1, 2019

Facilities with the same owner 35

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 35

Practitioners & affiliated clinicians

Affiliated clinicians 20

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705017600000",
    "number": "1851350086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W MACARTHUR ST STE 121",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748042005",
            "telephone_number": "405-878-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 PARK AVE STE 6",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202242",
            "telephone_number": "541-266-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC HOME CARE ASSOCIATES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-17",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A",
        "authorized_official_last_name": "FREEMAN",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-878-0202"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137518",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Home Health & Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pacific Home Health & Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coos Bay, OR

Sources for this page

Verify at the official NPI Registry.