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384 Se Combs Flat Rd Suite 1200 Prineville OR 97754-2562 | |
(541) 447-6263 | |
(541) 447-8724 |
Full Name | |
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Speciality | Clinic/Center |
Location | 384 Se Combs Flat Rd, Prineville, Oregon |
Authorized Official Name and Position | Matthew Swafford (CFO) |
Authorized Official Contact | 5413824321 |
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 6095 Bend OR 97708-6095 Ph: (541) 382-4321 | 384 Se Combs Flat Rd Suite 1200 Prineville OR 97754-2562 Ph: (541) 447-6263 |
NPI Number | 1407178528 |
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Provider Enumeration Date | 02/16/2010 |
Last Update Date | 05/05/2023 |
Medicare PECOS PAC ID | 3870402852 |
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Medicare Enrollment ID | O20100527000810 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407178528 | NPI | - | NPPES |
500642552 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
High Desert Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1251 Ne Elm Street, Prineville, OR 97754 Phone: 541-447-1680 Fax: 541-447-4670 | |
Mosaic Medical Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 375 Nw Beaver St Ste 101, Prineville, OR 97754 Phone: 541-408-9486 Fax: 541-647-2793 | |