| Saint Moscati Community Health Care | |
|
1880 Lancaster Dr Ne Ste 104 Salem OR 97305-1040 | |
| (971) 273-0679 | |
| (503) 961-0794 |
| Full Name | Saint Moscati Community Health Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 1880 Lancaster Dr Ne Ste 104, Salem, Oregon |
| Authorized Official Name and Position | Clara Castillo (ADMINISTRATIVE ASSISTANT) |
| Authorized Official Contact | 9712730679 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Saint Moscati Community Health Care 1880 Lancaster Dr Ne Ste 104 Salem OR 97305-1040 Ph: (971) 273-0679 | Saint Moscati Community Health Care 1880 Lancaster Dr Ne Ste 104 Salem OR 97305-1040 Ph: (971) 273-0679 |
| NPI Number | 1326589771 |
|---|---|
| Provider Enumeration Date | 03/18/2017 |
| Last Update Date | 04/04/2024 |
| Medicare PECOS PAC ID | 8426312497 |
|---|---|
| Medicare Enrollment ID | O20180430001138 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326589771 | NPI | - | NPPES |
| 500746269 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 201600993NP-PP (Oregon) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Esther E Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033190830 PECOS PAC ID: 5294881447 Enrollment ID: I20110425000148 |
| Provider Name | Juan L Castillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053778910 PECOS PAC ID: 5890094833 Enrollment ID: I20160426001934 |
| Provider Name | Bradley K Busey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720537814 PECOS PAC ID: 4284991274 Enrollment ID: I20171129002031 |
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