| Adapt | |
|
621 W Madrone St Roseburg OR 97470-3090 | |
| (541) 492-4550 | |
| (541) 492-4553 |
| Full Name | Adapt |
|---|---|
| Speciality | Clinic/Center |
| Location | 621 W Madrone St, Roseburg, Oregon |
| Authorized Official Name and Position | Michelle Monet Watson (CHIEF OPERATIONS OFFICER) |
| Authorized Official Contact | 5414924550 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adapt Po Box 1121 Roseburg OR 97470-0254 Ph: (541) 492-4550 | Adapt 621 W Madrone St Roseburg OR 97470-3090 Ph: (541) 492-4550 |
| NPI Number | 1861967648 |
|---|---|
| Provider Enumeration Date | 10/09/2018 |
| Last Update Date | 04/12/2022 |
| Medicare PECOS PAC ID | 4587662887 |
|---|---|
| Medicare Enrollment ID | O20220602000901 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861967648 | NPI | - | NPPES |
| 276245 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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