| Ontrack Rogue Valley | |
|
300 W. Main Street Medford OR 97501 | |
| (541) 772-1777 | |
| (541) 724-2410 |
| Full Name | Ontrack Rogue Valley |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 300 W. Main Street, Medford, Oregon |
| Authorized Official Name and Position | Alan Ledford (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5412002414 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ontrack Rogue Valley 300 W. Main Street Medford OR 97501 Ph: (541) 772-1777 | Ontrack Rogue Valley 300 W. Main Street Medford OR 97501 Ph: (541) 772-1777 |
| NPI Number | 1881685097 |
|---|---|
| Provider Enumeration Date | 11/04/2005 |
| Last Update Date | 03/12/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881685097 | NPI | - | NPPES |
| 020740000 | Other | OR | BLUE CROSS/SHIELD |
| H2152-01 | Other | OR | PACIFICSOURCE |
| 193813 | Medicaid | OR | |
| 117388 | Other | OR | MHN |
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