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280 S 1st Ave Mill City OR 97360-0003 | |
(503) 897-4100 | |
(503) 897-2673 |
Full Name | |
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Speciality | Clinic/Center |
Location | 280 S 1st Ave, Mill City, Oregon |
Authorized Official Name and Position | Maggie Hudson (COO / CFO) |
Authorized Official Contact | 5037699236 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 47 Mill City OR 97360-0047 Ph: (503) 897-4100 | 280 S 1st Ave Mill City OR 97360-0003 Ph: (503) 897-4100 |
NPI Number | 1396131389 |
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Provider Enumeration Date | 04/07/2015 |
Last Update Date | 04/07/2015 |
Medicare PECOS PAC ID | 6103729751 |
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Medicare Enrollment ID | O20150209001065 |
Identifier | Type | State | Issuer |
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1396131389 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |