Mid-Valley Healthcare Inc
Organization Active NPI Pain Medicine Physician · Lebanon, OR
NPI 1912940396 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1912940396
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pain Medicine Physician 208VP0000X
- Legal business name
- MID-VALLEY HEALTHCARE INC
- Practice address
- 100 Mullins Dr Ste C
Lebanon, OR 97355-3982 - Phone
- (541) 451-7460
- Fax
- (541) 451-7454
- NPI assigned
- Jun 14, 2006
- Organization subpart
- No
Authorized official
- Name
- Joseph M Cahill III
- Title
- Ceo
- Phone
- (541) 557-6441
Other NPIs on the same Medicare enrollment 27
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031111000297 | OR | Part B Supplier - Clinic/Group Practice | 2769391523 |
Receives reassigned benefits from 458 practitioners 27 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Lebanon, OR; Sweet Home, OR; Newport, OR; Halsey, OR; Brownsville, OR |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine Physician |
208VP0000X | Yes | ||
| Interventional Pain Medicine Physician |
208VP0014X |
Addresses
Primary practice location
100 Mullins Dr Ste C
Lebanon, OR 97355-3982
Mailing address
100 Mullins Drive, Suite C
Lebanon, OR 97355-2868
Phone (541) 451-7460
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2077698 | Other | PK | |
| 107318 | Medicaid | OR |
Other names
- Samaritan OMT Lebanon
Other providers in Lebanon, OR
- Mid Valley Healthcare Inc
- Mid Valley Healthcare Inc
- Mid-Valley Healthcare Inc
- Mid-Valley Healthcare Inc
- Mid-Valley Healthcare Inc
- Mid-Valley Healthcare, Inc
- Mid-Valley Healthcare, Inc.
- Mid-Valley Healthcare, Inc.
- Mid-Valley Healthcare, Inc.
- Mid-Valley Healthcare, Inc.
All providers in Lebanon, OR · Pain Medicine Physician in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.