| Lane Community College Health Clinic | |
|
4000 E 30th Ave Eugene OR 97405 | |
| (541) 463-5665 | |
| (541) 463-4164 |
| Full Name | Lane Community College Health Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 4000 E 30th Ave, Eugene, Oregon |
| Authorized Official Name and Position | Laura K Greene (CLINIC DIRECTOR) |
| Authorized Official Contact | 5414635665 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lane Community College Health Clinic 4000 E 30th Ave Eugene OR 97405 Ph: (541) 463-5665 | Lane Community College Health Clinic 4000 E 30th Ave Eugene OR 97405 Ph: (541) 463-5665 |
| NPI Number | 1497970891 |
|---|---|
| Provider Enumeration Date | 04/13/2007 |
| Last Update Date | 12/14/2016 |
| Medicare PECOS PAC ID | 7113327719 |
|---|---|
| Medicare Enrollment ID | O20210618002156 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497970891 | NPI | - | NPPES |
| 080046349RN | Other | OR | REGISTERED NURSE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 261QS1000X | Clinic/center - Student Health | 080046349RN (Oregon) | Primary |
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