Provider Demographics
NPI:1063896603
Name:AVANTE, LLC
Entity type:Organization
Organization Name:AVANTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HORNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-228-3662
Mailing Address - Street 1:1410 OAK ST
Mailing Address - Street 2:STE 101
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4604
Mailing Address - Country:US
Mailing Address - Phone:541-228-3265
Mailing Address - Fax:541-228-3855
Practice Address - Street 1:1410 OAK ST
Practice Address - Street 2:STE 101
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4604
Practice Address - Country:US
Practice Address - Phone:541-228-3265
Practice Address - Fax:541-228-3855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-14
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD228782086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR183608Medicare PIN