| Sherman County Medical Clinic | |
|
110 Main St Moro OR 97039-3080 | |
| (541) 565-0536 | |
| (541) 565-3617 |
| Full Name | Sherman County Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 110 Main St, Moro, Oregon |
| Authorized Official Name and Position | Caitlin M Blagg (DISTRICT ADMINISTRATOR) |
| Authorized Official Contact | 5415650536 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sherman County Medical Clinic Po Box 186 Moro OR 97039-0186 Ph: (541) 565-0536 | Sherman County Medical Clinic 110 Main St Moro OR 97039-3080 Ph: (541) 565-0536 |
| NPI Number | 1982692372 |
|---|---|
| Provider Enumeration Date | 10/10/2005 |
| Last Update Date | 05/10/2021 |
| Medicare PECOS PAC ID | 9335110238 |
|---|---|
| Medicare Enrollment ID | O20040804000583 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982692372 | NPI | - | NPPES |
| 165028 | Medicaid | OR | |
| 383820 | Other | OR | MEDICARE-PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Kristen G Dillon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649252362 PECOS PAC ID: 4385629666 Enrollment ID: I20040621001617 |
| Provider Name | Mark Corey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851372643 PECOS PAC ID: 5294818902 Enrollment ID: I20080218000588 |
| Provider Name | Tracy Willett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134118243 PECOS PAC ID: 4385976158 Enrollment ID: I20191028002341 |