Full Name | |
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Speciality | Clinic/Center |
Location | 142 E Dearborn, Union, Oregon |
Authorized Official Name and Position | James A Mattes (PRESIDENT/CEO) |
Authorized Official Contact | 5419631464 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 3290 La Grande OR 97850-7290 Ph: (541) 963-1555 | 142 E Dearborn Union OR 97883 Ph: (541) 963-1555 |
NPI Number | 1780068080 |
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Provider Enumeration Date | 07/16/2015 |
Last Update Date | 11/21/2016 |
Medicare PECOS PAC ID | 0547170789 |
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Medicare Enrollment ID | O20150909002653 |
Identifier | Type | State | Issuer |
---|---|---|---|
1780068080 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |