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322 Ne Eads St Newport OR 97365-2819 | |
(541) 265-8628 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 322 Ne Eads St, Newport, Oregon |
Authorized Official Name and Position | Lesa Wagner (CREDENTIALING SPECIALIST) |
Authorized Official Contact | 5412650445 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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36 Sw Nye St Newport OR 97365-3821 Ph: (541) 265-0468 | 322 Ne Eads St Newport OR 97365-2819 Ph: (541) 265-8628 |
NPI Number | 1932435377 |
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Provider Enumeration Date | 10/20/2009 |
Last Update Date | 04/07/2023 |
Medicare PECOS PAC ID | 3375439862 |
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Medicare Enrollment ID | O20060921000525 |
Identifier | Type | State | Issuer |
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1932435377 | NPI | - | NPPES |
213144 | Medicaid | OR |
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