Provider Demographics
NPI:1194900399
Name:ARNTZ MEDICAL
Entity type:Organization
Organization Name:ARNTZ MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:PETTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-573-6126
Mailing Address - Street 1:229 N EGAN
Mailing Address - Street 2:
Mailing Address - City:BURNS
Mailing Address - State:OR
Mailing Address - Zip Code:97720
Mailing Address - Country:US
Mailing Address - Phone:541-573-6126
Mailing Address - Fax:
Practice Address - Street 1:229 N EGAN
Practice Address - Street 2:
Practice Address - City:BURNS
Practice Address - State:OR
Practice Address - Zip Code:97720
Practice Address - Country:US
Practice Address - Phone:541-573-6126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR185157Medicaid
ORR01229Medicare UPIN