| Icco Llc | |
|
35859 Hwy 58 Pleasant Hill OR 97455 | |
| (541) 988-7300 | |
| (541) 988-7320 |
| Full Name | Icco Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 35859 Hwy 58, Pleasant Hill, Oregon |
| Authorized Official Name and Position | Peggy J Anderson (BILLING OFFICE MANAGER) |
| Authorized Official Contact | 5412283865 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Icco Llc 1292 High Street Suite 224 Eugene OR 97401 Ph: (541) 228-3865 | Icco Llc 35859 Hwy 58 Pleasant Hill OR 97455 Ph: (541) 988-7300 |
| NPI Number | 1922541184 |
|---|---|
| Provider Enumeration Date | 11/21/2016 |
| Last Update Date | 11/21/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922541184 | NPI | - | NPPES |
| DP1360 | Other | OR | RR MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Icco Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 35859 Highway 58, Pleasant Hill, OR 97455 Phone: 541-345-8760 Fax: 541-345-8763 | |
Bryce Willardson, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 83960 Spring Hill Ln, Pleasant Hill, OR 97455 Phone: 801-824-4334 |