Philip Broesamle, is a
Counselor - Addiction (substance Use Disorder) based in Shady Cove, Oregon. Philip Broesamle is licensed to practice in * (Not Available) (license number ) and his current practice location is
60 Mallory Ln., Shady Cove, Oregon. He can be reached at his office (for appointments etc.) via phone at
(541) 878-2658.
NPI number for Philip Broesamle is 1427444264 and his current mailing address is Po Box 323, Shady Cove, Oregon. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1427444264.
Healthcare Provider's Profile
| Full Name | Philip Broesamle |
|---|
| Gender | Male |
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| Speciality | Counselor - Addiction (substance Use Disorder) |
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| Location | 60 Mallory Ln., Shady Cove, Oregon |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1427444264
- Provider Enumeration Date: 04/08/2015
- Last Update Date: 04/08/2015
Medical Identifiers
Medical identifiers for Philip Broesamle such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1427444264 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Philip Broesamle is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Philip Broesamle,
Po Box 323,
Shady Cove, OR 97539
Ph: () - | Philip Broesamle,
60 Mallory Ln.,
Shady Cove, OR 97539
Ph: (541) 878-2658 |
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