Salem Clinic, Pc | |
1174 Cornucopia St Nw Ste 120 Salem OR 97304-3193 | |
(503) 399-2424 | |
(503) 375-7429 |
Full Name | Salem Clinic, Pc |
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Speciality | General Practice |
Location | 1174 Cornucopia St Nw Ste 120, Salem, Oregon |
Authorized Official Name and Position | Barbara Gunder (ADMINISTRATOR/CAO) |
Authorized Official Contact | 5033992470 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Salem Clinic, Pc Po Box 8100 Salem OR 97303-0900 Ph: (503) 399-2470 | Salem Clinic, Pc 1174 Cornucopia St Nw Ste 120 Salem OR 97304-3193 Ph: (503) 399-2424 |
NPI Number | 1962781526 |
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Provider Enumeration Date | 08/12/2011 |
Last Update Date | 08/12/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962781526 | NPI | - | NPPES |
179051 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
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