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603 Medical Pkwy Enterprise OR 97828-5124 | |
(541) 426-7900 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 603 Medical Pkwy, Enterprise, Oregon |
Authorized Official Name and Position | Joseph Matthew Wanner (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 5414265460 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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601 Medical Pkwy Enterprise OR 97828-5124 Ph: (541) 426-3111 | 603 Medical Pkwy Enterprise OR 97828-5124 Ph: (541) 426-7900 |
NPI Number | 1528442837 |
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Provider Enumeration Date | 07/16/2015 |
Last Update Date | 01/20/2017 |
Medicare PECOS PAC ID | 4183537566 |
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Medicare Enrollment ID | O20150730012349 |
Identifier | Type | State | Issuer |
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1528442837 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
282NC0060X | General Acute Care Hospital - Critical Access | 140068 (Oregon) | Secondary |
Winding Waters Clinic Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 603 Medical Pkwy, Enterprise, OR 97828 Phone: 541-426-4502 Fax: 541-426-6403 | |
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