| South Coast Healthcare | |
|
29641 Ellensburg Ave Gold Beach OR 97444-8701 | |
| (541) 698-8080 | |
| Not Available |
| Full Name | South Coast Healthcare |
|---|---|
| Speciality | Clinic/Center |
| Location | 29641 Ellensburg Ave, Gold Beach, Oregon |
| Authorized Official Name and Position | Sara E Dickerson (FAMILY NURSE PRACTITIONER) |
| Authorized Official Contact | 5414255657 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Coast Healthcare 29641 Ellensburg Ave Gold Beach OR 97444-8701 Ph: (541) 425-5657 | South Coast Healthcare 29641 Ellensburg Ave Gold Beach OR 97444-8701 Ph: (541) 698-8080 |
| NPI Number | 1134740152 |
|---|---|
| Provider Enumeration Date | 04/30/2020 |
| Last Update Date | 10/27/2020 |
| Medicare PECOS PAC ID | 1557780210 |
|---|---|
| Medicare Enrollment ID | O20200929002882 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134740152 | NPI | - | NPPES |
| 500783924 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Sara Dickerson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659616571 PECOS PAC ID: 8921436486 Enrollment ID: I20200316001204 |
Ati Urban Yates Md Facp Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 94220 4th St, Gold Beach, OR 97444 Phone: 541-247-3000 Fax: 702-453-5741 | |
Laine J Murphey Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 94220 4th St, Gold Beach, OR 97444 Phone: 541-525-0280 Fax: 702-453-5741 | |
Paul B Bascom Md Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 94220 4th St, Gold Beach, OR 97444 Phone: 503-961-2017 | |
Paul B Bascom Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 94220 4th St, Gold Beach, OR 97444 Phone: 503-961-2017 | |
Curry Child Abuse Intervention Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 94166 8th St, Gold Beach, OR 97444 Phone: 541-247-3340 | |
Michael O'gara Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 94125 4th St, Gold Beach, OR 97444 Phone: 541-247-6628 Fax: 541-247-6629 |