PEACEHEALTH (NPI# 1669578035) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669578035 |
| Entity Type | Organization |
| Organization Name | PEACEHEALTH |
| Other Organization Name | SOUTH LANE MEDICAL GROUP |
| Practice Address |
1515 Village Dr Cottage Grove OR 97424-9700 |
| Mailing Address |
Po Box 24410 Eugene OR 97402-0451 |
| Practice Telephone | 5419420511 |
| Mailing Telephone | 5413497683 |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2013-07-12 |
| Authorized Official Name | WENDY NMI APLAND (CFO) |
| Authorized Official Telephone | 5416863968 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 130008 | 05 |
| Other Name | Type Code |
|---|---|
| SOUTH LANE MEDICAL GROUP | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255977591 | Peacehealth | Durable Medical Equipment & Medical Supplies | 625 9th Ave Ste 120, Longview, WA 98632-2465 | 2019-11-21 |
| 1184106437 | Peacehealth | Durable Medical Equipment & Medical Supplies | Triangle Mall Suite 16 1015 Ocean Beach Hwy, Longview, WA 98632 | 2018-09-04 |
| 1669766457 | Peacehealth | General Acute Care Hospital | 787 Woodland Acres Ln, Eugene, OR 97402-9378 | 2011-06-09 |
| 1760427082 | Peacehealth | Home Health | 126 Washington St, Ketchikan, AK 99901-5930 | 2006-06-19 |
| 1912957986 | Peacehealth | Clinical Medical Laboratory | 123 International Way, Springfield, OR 97477-1047 | 2006-05-11 |
| 1083672273 | Peacehealth | Rehabilitation Unit | 809 E Chestnut St, Bellingham, WA 98225-5221 | 2006-05-04 |
| 1447217559 | Peacehealth | Hospice, Inpatient | 2800 Douglas Avenue, Bellingham, WA 98225 | 2006-05-01 |
| 1215918719 | Peacehealth | Hospice Care, Community Based | 2230 Kingwood Street, Florence, OR 97439-9470 | 2005-11-10 |
| 1225019011 | Peacehealth | Home Health | 2230 Kingwood St, Florence, OR 97439-9464 | 2005-11-08 |
| 1346237971 | Peacehealth | General Acute Care Hospital | 1255 Hilyard St, Eugene, OR 97401-3718 | 2005-09-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PEACEHEALTH | 1115 Se 164th Avenue, Vancouver, WA 98683-9324 |
| Washington State Corporations | PEACEHEALTH | 1115 Se 164th Ave Dept. 302, Vancouver, WA 98683 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH | 1115 Se 164th Ave Dept 302, Vancouver, WA 98683 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH - COTTAGE GROVE | 1515 Village Dr, Cottage Grove, OR 97424 |
| Washington State Corporations | PEACEHEALTH ASC BELLINGHAM, LLC | 1115 Se 164th Ave, Dept 302, Vancouver, WA 98683-9324 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH COTTAGE GROVE COMMUNITY MEDICAL CENTER | 1515 Village Dr, Cottage Grove, OR 97424 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH COTTAGE GROVE COMMUNITY MEDICAL CENTER FOUNDATION | 1515 Village Dr, Cottage Grove, OR 97424 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH COTTAGE GROVE COMMUNITY MEDICAL CENTER SWING | 1515 Village Drive, Cottage Grove, OR 97424 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH HOSPITAL MEDICINE | 3333 Riverbend Dr, Springfield, OR 97477 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH LABORATORIES | 123 International Way, Springfield, OR 97477 |
| Street Address |
1515 VILLAGE DR |
| City | COTTAGE GROVE |
| State | OR |
| Zip Code | 97424-9700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972507952 | Paul J Steier | Family Medicine | 1515 Village Dr, Cottage Grove, OR 97424-9700 | 2005-06-08 |
| 1942781489 | Kimberly Rae Stober | Nurse Practitioner | 1515 Village Dr, Cottage Grove, OR 97424-9700 | 2018-08-23 |
| 1760961288 | Mckinley Marie Hutchison | Nurse Practitioner | 1515 Village Dr, Cottage Grove, OR 97424-9700 | 2018-08-07 |
| 1083064737 | Maria Jane Holder | Nurse Practitioner | 1515 Village Dr, Cottage Grove, OR 97424-9700 | 2016-06-14 |
| 1538538327 | Brandy Bump Zerby | Physician Assistant | 1515 Village Dr, Cottage Grove, OR 97424-9700 | 2015-09-22 |
| 1487044376 | Rebecca Mcbride | Nurse Practitioner | 1515 Village Dr, Cottage Grove, OR 97424-9700 | 2015-01-29 |
| 1023450715 | Peace Health | Non-Pharmacy Dispensing Site | 1515 Village Dr, Cottage Grove, OR 97424-9700 | 2013-07-23 |
| 1104266956 | Jonathan Rafael Javier Lazaro | Family Medicine | 1515 Village Dr, Cottage Grove, OR 97424-9700 | 2013-06-26 |
| 1043564586 | Ehsan Hazrat | Family Medicine | 1515 Village Dr, Cottage Grove, OR 97424-9700 | 2012-11-06 |
| 1477816908 | Julie Ann Alcantara Galinato | Family Medicine | 1515 Village Dr, Cottage Grove, OR 97424-9700 | 2012-06-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851936157 | Naomi Higgs | Physical Therapy Assistant | 515 Grant St, Cottage Grove, OR 97424 | 2019-11-10 |
| 1588131296 | Home Town Drugs of Cottage Grove, Inc. | Pharmacy | 1205 Hwy 99 North, Cottage Grove, OR 97424 | 2018-10-31 |
| 1215420625 | Zachary Booth | Student in an Organized Health Care Education/Training Program | 28188 Cottage Grove Lorane Rd, Cottage Grove, OR 97424 | 2018-06-11 |
| 1124404090 | Eileen Nittler | Social Worker | 1345 Birch Avenue, Cottage Grove, OR 97424 | 2015-08-03 |
| 1851799787 | Kathryn Brooks | Licensed Practical Nurse | 520 Patrick Loop, Cottage Grove, OR 97424 | 2014-12-09 |
| 1558767814 | Michele Renee Savage | Orthotic Fitter | 148 Gateway Blvd, Cottage Grove, OR 97424 | 2014-11-14 |
| 1730598558 | John Mansfield | Pharmacist | 120 Andrew Drive, Cottage Grove, OR 97424 | 2014-08-06 |
| 1700213493 | Aspen Injury Center LLC | Chiropractor | 1260 East Main Street, Cottage Grove, OR 97424 | 2013-09-26 |
| 1609172956 | Megan Olds | Counselor | 37 South 6th Street, Cottage Grove, OR 97424 | 2011-02-03 |
| 1144530726 | Monica G Radley | Counselor | 1345 Birch Ave., Cottage Grove, OR 97424 | 2010-10-15 |
| Find all providers in zip 97424 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730519562 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 9300 E Point Douglas Rd S, Cottage Grove, MN 55016-4030 | 2013-11-14 |
| 1952678591 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 605 W. Cottage Grove Rd., Cottage Grove, WI 53527-9222 | 2011-11-28 |
| 1629242102 | Assisted Living Store, Incorporated | Durable Medical Equipment & Medical Supplies | 7687 Hyde Ave S, Cottage Grove, MN 55016-1978 | 2008-04-16 |
| 1972609584 | Mccoy's Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 632 E Main St, Cottage Grove, OR 97424-2038 | 2006-09-15 |
| 1861507907 | Supervalu Pharmacies Inc | Durable Medical Equipment & Medical Supplies | 8690 E Point Douglas Rd S, Cottage Grove, MN 55016 | 2006-08-20 |
| 1225043532 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 7135 E Point Douglas Rd S, Cottage Grove, MN 55016-3014 | 2006-07-29 |
| 1417974569 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 901 Row River Rd, Cottage Grove, OR 97424-9558 | 2006-07-16 |
| 1457384711 | Bimart Corporation | Durable Medical Equipment & Medical Supplies | 100 Gateway Blvd, Cottage Grove, OR 97424-1741 | 2006-07-09 |
| 1801842729 | Healtheast Medical Research Institute | Durable Medical Equipment & Medical Supplies | 6936 Pine Arbor Drive South, Suite 100, Cottage Grove, MN 55016-3007 | 2006-05-25 |
| 1629038815 | University of Wisconsin Medical Foundation Inc | Durable Medical Equipment & Medical Supplies | 4590 County Rd N, Cottage Grove, WI 53527-9208 | 2006-03-23 |
| Find all providers in COTTAGE GROVE | ||||
| City | COTTAGE GROVE |
| Zip Code | 97424 |
Please comment or provide details below to improve the information on PEACEHEALTH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.