Provider Demographics
NPI:1346998630
Name:PG HOME HEALTH INC
Entity type:Organization
Organization Name:PG HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:NDEGWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:774-262-7975
Mailing Address - Street 1:10941 SE BUSH ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97266-2268
Mailing Address - Country:US
Mailing Address - Phone:774-262-7975
Mailing Address - Fax:
Practice Address - Street 1:10941 SE BUSH ST
Practice Address - Street 2:UNIT 1
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97266-2268
Practice Address - Country:US
Practice Address - Phone:774-262-7975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-15
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health