| Adapt | |
|
548 Se Jackson St Roseburg OR 97470-4983 | |
| (541) 492-4550 | |
| Not Available |
| Full Name | Adapt |
|---|---|
| Speciality | Clinic/Center |
| Location | 548 Se Jackson St, Roseburg, Oregon |
| Authorized Official Name and Position | Debbie L Phillips (DIRECTOR OF BILLING) |
| Authorized Official Contact | 5414920134 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adapt 621 W Madrone St Roseburg OR 97470-3090 Ph: (541) 492-0134 | Adapt 548 Se Jackson St Roseburg OR 97470-4983 Ph: (541) 492-4550 |
| NPI Number | 1750975553 |
|---|---|
| Provider Enumeration Date | 02/23/2021 |
| Last Update Date | 02/23/2021 |
| Certification Date | 02/23/2021 |
| Medicare PECOS PAC ID | 4587662887 |
|---|---|
| Medicare Enrollment ID | O20220505001481 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750975553 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (NU) | Primary |
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