| Lancaster Family Health Center | |
|
3896 Beverly Ave Ne Ste 40 Building J Salem OR 97305-1374 | |
| (503) 588-0076 | |
| (503) 588-0531 |
| Full Name | Lancaster Family Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 3896 Beverly Ave Ne Ste 40 Building J, Salem, Oregon |
| Authorized Official Name and Position | Juan Carlos Olivares (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5098656175 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lancaster Family Health Center Po Box 190 Toppenish WA 98948-0190 Ph: (503) 588-0076 | Lancaster Family Health Center 3896 Beverly Ave Ne Ste 40 Building J Salem OR 97305-1374 Ph: (503) 588-0076 |
| NPI Number | 1972684710 |
|---|---|
| Provider Enumeration Date | 10/18/2006 |
| Last Update Date | 02/12/2008 |
| Medicare PECOS PAC ID | 4385541986 |
|---|---|
| Medicare Enrollment ID | O20201008001894 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972684710 | NPI | - | NPPES |
| CD9420 | Other | OR | RAILROAD MEDICARE |
| 022793 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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