Provider Demographics
NPI:1699426684
Name:ASANTE
Entity type:Organization
Organization Name:ASANTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PAYER CONTRACTING PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TONI
Authorized Official - Middle Name:A
Authorized Official - Last Name:BARTLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-789-4728
Mailing Address - Street 1:2650 SISKIYOU BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-8304
Mailing Address - Country:US
Mailing Address - Phone:541-789-4728
Mailing Address - Fax:541-789-5393
Practice Address - Street 1:3011 EAST BARNETT RD
Practice Address - Street 2:PHARMACY SUITE
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504
Practice Address - Country:US
Practice Address - Phone:541-789-5547
Practice Address - Fax:541-789-5678
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASANTE DBA ROGUE REGIONAL MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy