| Rch Main Dental | |
|
922 E Main St Medford OR 97504-7136 | |
| (541) 773-3863 | |
| (541) 773-2892 |
| Full Name | Rch Main Dental |
|---|---|
| Speciality | Clinic/Center |
| Location | 922 E Main St, Medford, Oregon |
| Authorized Official Name and Position | Calisa Warnke (CFO ADMINISTRATION OFFICER) |
| Authorized Official Contact | 5418427642 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rch Main Dental 1000 E Main St Medford OR 97504-7667 Ph: (541) 930-5611 | Rch Main Dental 922 E Main St Medford OR 97504-7136 Ph: (541) 773-3863 |
| NPI Number | 1225773013 |
|---|---|
| Provider Enumeration Date | 05/05/2022 |
| Last Update Date | 09/08/2022 |
| Medicare PECOS PAC ID | 1557266236 |
|---|---|
| Medicare Enrollment ID | O20221019001448 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225773013 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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