1245360361 NPI number — PLANNED PARENTHOOD OF SOUTHWESTERN OREGON

Table of content: LORETTA L BEULE C.N.P. (NPI 1609835503)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245360361 NPI number — PLANNED PARENTHOOD OF SOUTHWESTERN OREGON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PLANNED PARENTHOOD OF SOUTHWESTERN OREGON
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245360361
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/01/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3579 FRANKLIN BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EUGENE
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97403-2356
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-344-2632
Provider Business Mailing Address Fax Number:
541-344-6519

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4969 HIGHWAY 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLORENCE
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97439-7803
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-344-2632
Provider Business Practice Location Address Fax Number:
541-344-6519
Provider Enumeration Date:
03/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HALL
Authorized Official First Name:
KELLY
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF PATIENT SERVICES
Authorized Official Telephone Number:
541-344-2632

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  MD21490 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QF0050X , with the licence number: MD12242 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 320332 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".




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