| Wallowa Memorial Medical Clinic - Downtown | |
|
306 W North St Enterprise OR 97828-1041 | |
| (541) 426-7900 | |
| Not Available |
| Full Name | Wallowa Memorial Medical Clinic - Downtown |
|---|---|
| Speciality | Clinic/Center |
| Location | 306 W North St, Enterprise, Oregon |
| Authorized Official Name and Position | Joseph Wanner (CFO) |
| Authorized Official Contact | 5414265460 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wallowa Memorial Medical Clinic - Downtown 601 Medical Pkwy Enterprise OR 97828-5124 Ph: (541) 426-3111 | Wallowa Memorial Medical Clinic - Downtown 306 W North St Enterprise OR 97828-1041 Ph: (541) 426-7900 |
| NPI Number | 1295338333 |
|---|---|
| Provider Enumeration Date | 11/20/2020 |
| Last Update Date | 01/31/2023 |
| Medicare PECOS PAC ID | 4183537566 |
|---|---|
| Medicare Enrollment ID | O20210209002035 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295338333 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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