| Main Street Family Medicine | |
|
191 N Main St Lebanon OR 97355-2870 | |
| (541) 451-7940 | |
| Not Available |
| Full Name | Main Street Family Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 191 N Main St, Lebanon, Oregon |
| Authorized Official Name and Position | Joseph M Cahill (CEO) |
| Authorized Official Contact | 5414517107 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Street Family Medicine 191 N Main St Lebanon OR 97355-2870 Ph: (541) 451-7940 | Main Street Family Medicine 191 N Main St Lebanon OR 97355-2870 Ph: (541) 451-7940 |
| NPI Number | 1154687309 |
|---|---|
| Provider Enumeration Date | 04/02/2012 |
| Last Update Date | 10/25/2018 |
| Medicare PECOS PAC ID | 2769391523 |
|---|---|
| Medicare Enrollment ID | O20180419001624 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154687309 | NPI | - | NPPES |
| 500651455 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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