Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 365 W 3rd St, Ione, Oregon |
Authorized Official Name and Position | Patti Allstott (ADMIN COORDINATOR) |
Authorized Official Contact | 5416762932 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 9 Heppner OR 97836 Ph: (541) 676-9133 | 365 W 3rd St Ione OR 97843-7216 Ph: (541) 676-9133 |
NPI Number | 1477945517 |
---|---|
Provider Enumeration Date | 02/26/2015 |
Last Update Date | 05/24/2016 |
Medicare PECOS PAC ID | 2365359296 |
---|---|
Medicare Enrollment ID | O20150707001660 |
Identifier | Type | State | Issuer |
---|---|---|---|
1477945517 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 141444 (Oregon) | Primary |