Provider Demographics
NPI:1962411900
Name:PARKO INC
Entity type:Organization
Organization Name:PARKO INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:PATRICE
Authorized Official - Last Name:WINNEN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:503-472-2147
Mailing Address - Street 1:228 NE 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-4819
Mailing Address - Country:US
Mailing Address - Phone:503-472-2147
Mailing Address - Fax:503-437-9206
Practice Address - Street 1:228 NE 3RD ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-4819
Practice Address - Country:US
Practice Address - Phone:503-472-2147
Practice Address - Fax:503-437-9206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR269216Medicaid
OR269216Medicaid