Provider Demographics
NPI:1487257424
Name:HERITAGE HOSPICE LLC
Entity type:Organization
Organization Name:HERITAGE HOSPICE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUMGARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:971-303-1140
Mailing Address - Street 1:9126 SW RIDDER RD
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-6766
Mailing Address - Country:US
Mailing Address - Phone:503-542-7090
Mailing Address - Fax:503-776-7436
Practice Address - Street 1:9126 SW RIDDER RD # A
Practice Address - Street 2:
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070-6766
Practice Address - Country:US
Practice Address - Phone:503-542-7090
Practice Address - Fax:503-776-7436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-20
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based