| Icco, Llc | |
|
87983 Territorial Hwy Veneta OR 97487 | |
| (541) 935-2200 | |
| (541) 998-4571 |
| Full Name | Icco, Llc |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 87983 Territorial Hwy, Veneta, Oregon |
| Authorized Official Name and Position | Erica Hauser (DIRECTOR) |
| Authorized Official Contact | 3125905372 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Icco, Llc Po Box 4858 Portland OR 97208-4858 Ph: () - | Icco, Llc 87983 Territorial Hwy Veneta OR 97487 Ph: (541) 935-2200 |
| NPI Number | 1245810233 |
|---|---|
| Provider Enumeration Date | 04/13/2021 |
| Last Update Date | 06/20/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245810233 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Icco, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 25045 Dunham Avenue, Veneta, OR 97487 Phone: 541-935-2035 | |
G Street Integrated Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 87983 Territorial Rd, Veneta, OR 97487 Phone: 541-935-6922 Fax: 541-747-9870 | |
Icco, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 87983 Territorial Rd, Veneta, OR 97487 Phone: 541-935-2200 Fax: 541-935-6241 |