| New Life Family Medicine Llc | |
|
842 Commercial Street Ne Salem OR 97302 | |
| (503) 586-8291 | |
| Not Available |
| Full Name | New Life Family Medicine Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 842 Commercial Street Ne, Salem, Oregon |
| Authorized Official Name and Position | Linda C Bird (OWNER/NURSE PRACTITIONER) |
| Authorized Official Contact | 5035868291 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Life Family Medicine Llc Po Box 5485 Salem OR 97304-0485 Ph: (503) 586-8291 | New Life Family Medicine Llc 842 Commercial Street Ne Salem OR 97302 Ph: (503) 586-8291 |
| NPI Number | 1588113278 |
|---|---|
| Provider Enumeration Date | 09/23/2016 |
| Last Update Date | 01/26/2017 |
| Medicare PECOS PAC ID | 5395027320 |
|---|---|
| Medicare Enrollment ID | O20170126001215 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588113278 | NPI | - | NPPES |
| 116907 | Other | OR | MEDICARE ID |
| 210764 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 099006422N1 (Oregon) | Primary |
| 261QP2300X | Clinic/center - Primary Care | 099006422RN (Oregon) | Secondary |
| Provider Name | Linda C Bird |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013050301 PECOS PAC ID: 7618054065 Enrollment ID: I20120126000831 |
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