| Beavercreek Health Clinic | |
|
110 Beavercreek Rd Ste 100 Oregon City OR 97045-4307 | |
| (503) 655-8471 | |
| (503) 655-8595 |
| Full Name | Beavercreek Health Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 110 Beavercreek Rd Ste 100, Oregon City, Oregon |
| Authorized Official Name and Position | Ed Johnson (CFO) |
| Authorized Official Contact | 5037425325 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beavercreek Health Clinic 2051 Kaen Rd Suite 367 Oregon City OR 97045-4035 Ph: (503) 742-5300 | Beavercreek Health Clinic 110 Beavercreek Rd Ste 100 Oregon City OR 97045-4307 Ph: (503) 655-8471 |
| NPI Number | 1720017809 |
|---|---|
| Provider Enumeration Date | 07/01/2006 |
| Last Update Date | 09/24/2019 |
| Medicare PECOS PAC ID | 9537065560 |
|---|---|
| Medicare Enrollment ID | O20080912000100 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720017809 | NPI | - | NPPES |
| 022710 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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