Rogue River Family Practice Clinic Pc | |
509 E Main Street Rogue River OR 97537-9674 | |
(541) 582-0505 | |
(541) 582-0778 |
Full Name | Rogue River Family Practice Clinic Pc |
---|---|
Speciality | Family Medicine |
Location | 509 E Main Street, Rogue River, Oregon |
Authorized Official Name and Position | Edmund H Glovinsky (PARTNER) |
Authorized Official Contact | 5415820505 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Rogue River Family Practice Clinic Pc Po Box 1020 Rogue River OR 97537-9674 Ph: (541) 582-0505 | Rogue River Family Practice Clinic Pc 509 E Main Street Rogue River OR 97537-9674 Ph: (541) 582-0505 |
NPI Number | 1477613529 |
---|---|
Provider Enumeration Date | 12/11/2006 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 9133120090 |
---|---|
Medicare Enrollment ID | O20070122000092 |
Identifier | Type | State | Issuer |
---|---|---|---|
1477613529 | NPI | - | NPPES |
113597 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Brian J Mateja |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1063417772 PECOS PAC ID: 8325036908 Enrollment ID: I20050830000444 |
Provider Name | Heather Calleen Merlo-grifantini |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1346401742 PECOS PAC ID: 6608046321 Enrollment ID: I20110906000726 |
Provider Name | David Ray |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811135759 PECOS PAC ID: 0749346732 Enrollment ID: I20150324000929 |
Provider Name | Chelsey Noel Pauls |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255043782 PECOS PAC ID: 0749651347 Enrollment ID: I20230118001544 |
Rogue River Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 216 E Main St, Rogue River, OR 97537 Phone: 541-582-8899 |