| |
2200 Ne Professional Ct Bend OR 97701-6063 | |
(541) 389-6313 | |
Not Available |
Full Name | |
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Speciality | Clinic/center |
Location | 2200 Ne Professional Ct, Bend, Oregon |
Authorized Official Name and Position | Keenan B Freeman (CFO) |
Authorized Official Contact | 5038936524 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 3158 Portland OR 97208-3158 Ph: (503) 215-6494 | 2200 Ne Professional Ct Bend OR 97701-6063 Ph: (541) 389-6313 |
NPI Number | 1194996991 |
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Provider Enumeration Date | 03/19/2008 |
Last Update Date | 09/25/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194996991 | NPI | - | NPPES |
279130 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Pine Springs Health Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 711 Ne Irving Ave, Bend, OR 97701 Phone: 541-330-9110 | |
Adam Derr, P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 528 Ne Greenwood Ave, Bend, OR 97701 Phone: 541-385-7890 Fax: 541-388-2606 | |
Driven Enterprises Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 20700 Wandalea Dr, Bend, OR 97701 Phone: 435-669-2930 | |