| Mercy Behavioral Health Services | |
|
2700 Nw Stewart Pkwy Roseburg OR 97470-1281 | |
| (541) 677-2458 | |
| (541) 677-1554 |
| Full Name | Mercy Behavioral Health Services |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 2700 Nw Stewart Pkwy, Roseburg, Oregon |
| Authorized Official Name and Position | John S Kasberger (VICE PRESIDENT CFO) |
| Authorized Official Contact | 5416772458 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy Behavioral Health Services 2700 Nw Stewart Pkwy Roseburg OR 97471-1281 Ph: (541) 677-2458 | Mercy Behavioral Health Services 2700 Nw Stewart Pkwy Roseburg OR 97470-1281 Ph: (541) 677-2458 |
| NPI Number | 1811038367 |
|---|---|
| Provider Enumeration Date | 02/09/2007 |
| Last Update Date | 08/30/2008 |
| Medicare PECOS PAC ID | 9234047697 |
|---|---|
| Medicare Enrollment ID | O20031111000222 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811038367 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 141133 (Oregon) | Primary |
| Provider Name | Frederic J Vandis |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1093786261 PECOS PAC ID: 9234122995 Enrollment ID: I20040610001502 |
| Provider Name | Kurt A Brickner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023092178 PECOS PAC ID: 5991788853 Enrollment ID: I20040610001563 |
| Provider Name | Jocarol Driver |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1316078009 PECOS PAC ID: 3072605120 Enrollment ID: I20070822000396 |
| Provider Name | Bryan M Mcvay |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1356517098 PECOS PAC ID: 2668528290 Enrollment ID: I20090923000011 |
| Provider Name | Joel H Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790768877 PECOS PAC ID: 2961592704 Enrollment ID: I20091216000662 |
| Provider Name | Bret R Hansen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1164406211 PECOS PAC ID: 9032209879 Enrollment ID: I20100104000613 |
| Provider Name | Robert G Kloepper |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1295705481 PECOS PAC ID: 8224923354 Enrollment ID: I20110119000787 |
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