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270 Gazley Bridge Rd Canyonville OR 97417-9718 | |
| (541) 839-1345 | |
| (855) 670-1791 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 270 Gazley Bridge Rd, Canyonville, Oregon |
| Authorized Official Name and Position | Sharon A Stanphill (CHIEF HEALTH OFFICER) |
| Authorized Official Contact | 5416728533 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
270 Gazley Bridge Rd Canyonville OR 97417-9718 Ph: (541) 839-1345 | 270 Gazley Bridge Rd Canyonville OR 97417-9718 Ph: (541) 839-1345 |
| NPI Number | 1205162021 |
|---|---|
| Provider Enumeration Date | 10/29/2009 |
| Last Update Date | 08/05/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205162021 | NPI | - | NPPES |
| 500745176 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (Oregon) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Falk Family Medicine, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 115 Sw Pine Street, Canyonville, OR 97417 Phone: 541-839-4211 Fax: 541-839-4983 |