| Medford Treatment Center | |
|
750 Biddle Rd Ste 102 Medford OR 97504-6178 | |
| (541) 208-1785 | |
| (541) 653-8196 |
| Full Name | Medford Treatment Center |
|---|---|
| Speciality | Clinic/center |
| Location | 750 Biddle Rd Ste 102, Medford, Oregon |
| Authorized Official Name and Position | Dana Jorgensen (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 5413221794 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medford Treatment Center 750 Biddle Rd Ste 102 Medford OR 97504-6178 Ph: (541) 208-1785 | Medford Treatment Center 750 Biddle Rd Ste 102 Medford OR 97504-6178 Ph: (541) 208-1785 |
| NPI Number | 1427680057 |
|---|---|
| Provider Enumeration Date | 02/11/2020 |
| Last Update Date | 09/16/2021 |
| Certification Date | 09/16/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427680057 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| 261QM2800X | Clinic/center - Methadone | () | Secondary |
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