| Glendale Community Primary Care | |
|
101 1st St Glendale OR 97442-9640 | |
| (541) 832-5400 | |
| Not Available |
| Full Name | Glendale Community Primary Care |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 101 1st St, Glendale, Oregon |
| Authorized Official Name and Position | Leona Marie Anderson (PRESIDENT) |
| Authorized Official Contact | 5418325400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Glendale Community Primary Care Po Box 293 Glendale OR 97442-0293 Ph: (541) 832-5400 | Glendale Community Primary Care 101 1st St Glendale OR 97442-9640 Ph: (541) 832-5400 |
| NPI Number | 1114480399 |
|---|---|
| Provider Enumeration Date | 04/13/2019 |
| Last Update Date | 08/10/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114480399 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |