Provider Demographics
NPI:1215761002
Name:OREGON HEALTHCARE RESOURCES, LLC
Entity type:Organization
Organization Name:OREGON HEALTHCARE RESOURCES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF OHR PHYSICIAN GROUP, P.C.
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:GLEN
Authorized Official - Last Name:GRAGNOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-731-7518
Mailing Address - Street 1:PO BOX 1648
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97440-1648
Mailing Address - Country:US
Mailing Address - Phone:541-687-4900
Mailing Address - Fax:541-463-2820
Practice Address - Street 1:600 COUNTRY CLUB RD STE 100
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2240
Practice Address - Country:US
Practice Address - Phone:541-463-2390
Practice Address - Fax:541-463-2889
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OREGON HEALTHCARE RESOURCES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care