| La Clinica School- Based Health Center At Patrick Elementary School | |
|
1500 2nd Ave Gold Hill OR 97525-9728 | |
| (541) 494-6818 | |
| (541) 494-6816 |
| Full Name | La Clinica School- Based Health Center At Patrick Elementary School |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1500 2nd Ave, Gold Hill, Oregon |
| Authorized Official Name and Position | Tara Lynette Jeannot (CHIEF OPERATIONS OFFICER) |
| Authorized Official Contact | 5415356239 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| La Clinica School- Based Health Center At Patrick Elementary School 931 Chevy Way Medford OR 97504-4127 Ph: (541) 535-6239 | La Clinica School- Based Health Center At Patrick Elementary School 1500 2nd Ave Gold Hill OR 97525-9728 Ph: (541) 494-6818 |
| NPI Number | 1730663790 |
|---|---|
| Provider Enumeration Date | 09/17/2018 |
| Last Update Date | 07/15/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730663790 | NPI | - | NPPES |
| 022868 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
La Clinica School- Based Health Center At Hanby Middle School Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 806 6th Ave N, Gold Hill, OR 97525 Phone: 541-494-6818 Fax: 541-494-6816 |