Family Care Center Pc | |
1001 Nw Canal Blvd Ste 101 Redmond OR 97756-1697 | |
(541) 548-8088 | |
(541) 548-8018 |
Full Name | Family Care Center Pc |
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Speciality | Family Medicine |
Location | 1001 Nw Canal Blvd Ste 101, Redmond, Oregon |
Authorized Official Name and Position | Rose J Kenny (PHYSICIAN) |
Authorized Official Contact | 5415488088 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Family Care Center Pc 1001 Nw Canal Blvd Ste 101 Redmond OR 97756-1697 Ph: (541) 548-8088 | Family Care Center Pc 1001 Nw Canal Blvd Ste 101 Redmond OR 97756-1697 Ph: (541) 548-8088 |
NPI Number | 1508832411 |
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Provider Enumeration Date | 02/28/2006 |
Last Update Date | 01/25/2018 |
Medicare PECOS PAC ID | 4688669153 |
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Medicare Enrollment ID | O20040415000906 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508832411 | NPI | - | NPPES |
228793 | Medicaid | OR | |
1194975037 | Other | OR | INDIVIDUAL NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | MD23253 (Oregon) | Primary |
Provider Name | Rose J Kenny |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1194975037 PECOS PAC ID: 1557356029 Enrollment ID: I20081016000344 |
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