| Umpqua Community Health Center, Inc. | |
|
775 Taylor St. Sutherlin OR 97479 | |
| (541) 672-9596 | |
| Not Available |
| Full Name | Umpqua Community Health Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 775 Taylor St., Sutherlin, Oregon |
| Authorized Official Name and Position | Kc Bolton (CEO) |
| Authorized Official Contact | 5416729596 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Umpqua Community Health Center, Inc. 150 Ne Kenneth Ford Dr Roseburg OR 97470-1042 Ph: (541) 672-9596 | Umpqua Community Health Center, Inc. 775 Taylor St. Sutherlin OR 97479 Ph: (541) 672-9596 |
| NPI Number | 1619399888 |
|---|---|
| Provider Enumeration Date | 01/07/2014 |
| Last Update Date | 01/02/2024 |
| Medicare PECOS PAC ID | 0345233078 |
|---|---|
| Medicare Enrollment ID | O20141001002166 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619399888 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Centennial Medical Group East, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 249 Dakota St, Sutherlin, OR 97479 Phone: 541-677-7200 Fax: 541-229-3309 | |
Sutherlin Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 781 W Central Ave, Sutherlin, OR 97479 Phone: 541-459-0303 Fax: 541-459-1657 |