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35 Mullins Drive Suite 2 Lebanon OR 97355 | |
(541) 451-7915 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 35 Mullins Drive, Lebanon, Oregon |
Authorized Official Name and Position | Becky A Pape (CEO) |
Authorized Official Contact | 5414517107 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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35 Mullins Drive Suite 2 Lebanon OR 97355 Ph: (541) 451-7915 | 35 Mullins Drive Suite 2 Lebanon OR 97355 Ph: (541) 451-7915 |
NPI Number | 1508122763 |
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Provider Enumeration Date | 04/02/2012 |
Last Update Date | 07/02/2019 |
Medicare PECOS PAC ID | 2769391523 |
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Medicare Enrollment ID | O20190131003184 |
Identifier | Type | State | Issuer |
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1508122763 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |