| Joseph Peter Lulich, FNP-C | |
|
280 S 1st Ave, Mill City, OR 97360-2324 | |
| (503) 897-4100 | |
| (503) 897-2673 |
| Full Name | Joseph Peter Lulich |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 16 Years |
| Location | 280 S 1st Ave, Mill City, Oregon |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134451784 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 201150029 (Oregon) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Santiam Hospital & Clinics | Stayton, OR | Hospital |
| Salem Hospital | Salem, OR | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Icco Llc | 1355406729 | 133 |
| Entity Name | Santiam Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154302214 PECOS PAC ID: 6103729751 Enrollment ID: O20040130000239 |
| Entity Name | Icco LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407004757 PECOS PAC ID: 1355406729 Enrollment ID: O20090218000510 |
| Mailing Address | Practice Location Address |
|---|---|
| Joseph Peter Lulich, FNP-C Po Box 47, Mill City, OR 97360-0047 Ph: (503) 897-4100 | Joseph Peter Lulich, FNP-C 280 S 1st Ave, Mill City, OR 97360-2324 Ph: (503) 897-4100 |
Jessica Leigh Grim, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 280 S 1st Ave, Mill City, OR 97360 Phone: 503-897-4100 |
Johannah Marie Gregg, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 280 S 1st Ave, Mill City, OR 97360 Phone: 503-897-4100 Fax: 503-897-2673 |