Provider Demographics
NPI:1306966536
Name:HILLSBORO CARDIOLOGY, PC
Entity type:Organization
Organization Name:HILLSBORO CARDIOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:CONROY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-648-0731
Mailing Address - Street 1:333 SE 7TH AVE STE 5400
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4165
Mailing Address - Country:US
Mailing Address - Phone:503-648-0731
Mailing Address - Fax:503-640-2747
Practice Address - Street 1:333 SE 7TH AVE STE 5400
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4165
Practice Address - Country:US
Practice Address - Phone:503-648-0731
Practice Address - Fax:503-640-2747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR021811Medicaid
OR198168Medicaid
OR198168Medicaid
OR021811Medicaid
ORA41802Medicare UPIN
OR0000BKWBGMedicare ID - Type Unspecified