| Icco Llc | |
|
420 Smith St Harrisburg OR 97446 | |
| (541) 995-5266 | |
| (541) 995-5245 |
| Full Name | Icco Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 420 Smith St, Harrisburg, Oregon |
| Authorized Official Name and Position | Douglas D Bailey (MEDICAL DIRECTOR HARRISBURG CLINIC) |
| Authorized Official Contact | 5419986750 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Icco Llc 1292 High St Suite 224 Eugene OR 97401-3238 Ph: (541) 641-6053 | Icco Llc 420 Smith St Harrisburg OR 97446 Ph: (541) 995-5266 |
| NPI Number | 1922458371 |
|---|---|
| Provider Enumeration Date | 06/16/2016 |
| Last Update Date | 06/13/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922458371 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (Oregon) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (Oregon) | Secondary |