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320 Central Ave Suite 418 Coos Bay OR 97420-2272 | |
(541) 294-0257 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | 320 Central Ave, Coos Bay, Oregon |
Authorized Official Name and Position | Anthony Baldacci (OWNER, MANAGING MEMBER) |
Authorized Official Contact | 5412940257 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 1733 Coos Bay OR 97420-0339 Ph: () - | 320 Central Ave Suite 418 Coos Bay OR 97420-2272 Ph: (541) 294-0257 |
NPI Number | 1124412051 |
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Provider Enumeration Date | 03/28/2015 |
Last Update Date | 03/28/2015 |
Identifier | Type | State | Issuer |
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1124412051 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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