Samaritan Waldport Clinic | |
920 Sw Range Drive Waldport OR 97394-3035 | |
(541) 563-3197 | |
Not Available |
Full Name | Samaritan Waldport Clinic |
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Speciality | Clinic/Center |
Location | 920 Sw Range Drive, Waldport, Oregon |
Authorized Official Name and Position | David C. Bigelow (CEO) |
Authorized Official Contact | 5415741801 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Samaritan Waldport Clinic Po Box 2847 Corvallis OR 97339-2847 Ph: (541) 563-3197 | Samaritan Waldport Clinic 920 Sw Range Drive Waldport OR 97394-3035 Ph: (541) 563-3197 |
NPI Number | 1619047503 |
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Provider Enumeration Date | 11/08/2006 |
Last Update Date | 06/02/2016 |
Medicare PECOS PAC ID | 2466353529 |
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Medicare Enrollment ID | O20150512002971 |
Identifier | Type | State | Issuer |
---|---|---|---|
1619047503 | NPI | - | NPPES |
286758 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Lincoln County Health & Human Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3000 S Crestline Dr, Waldport, OR 97394 Phone: 541-265-0471 Fax: 541-650-5662 |