Pine Springs Health Llc | |
711 Ne Irving Ave Bend OR 97701-4738 | |
(541) 330-9110 | |
Not Available |
Full Name | Pine Springs Health Llc |
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Speciality | Clinic/Center |
Location | 711 Ne Irving Ave, Bend, Oregon |
Authorized Official Name and Position | Divya Sharma (OWNER) |
Authorized Official Contact | 5414802807 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Pine Springs Health Llc 711 Ne Irving Ave Bend OR 97701-4738 Ph: (541) 330-9110 | Pine Springs Health Llc 711 Ne Irving Ave Bend OR 97701-4738 Ph: (541) 330-9110 |
NPI Number | 1013697994 |
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Provider Enumeration Date | 07/24/2023 |
Last Update Date | 12/06/2024 |
Medicare PECOS PAC ID | 0547617797 |
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Medicare Enrollment ID | O20231108003996 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013697994 | NPI | - | NPPES |
500830385 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Divya Sharma |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1083679393 PECOS PAC ID: 6204875974 Enrollment ID: I20121106000685 |
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