| Organization Name: | BANDON COMMUNITY HEALTH CENTER |
| NPI Number: | 1033348289 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LINDA S MAXON (EXECUTIVE DIRECTOR) |
| Mailing Address: | 1010 1st St Se Bandon |
| State: | OR US |
| Postal Code: | 974119301 |
| Phone Number: | 5413472529 |
| Fax Number: | 5413479196 |
| NPI Enumeration Date: | 07/09/2009 |
| NPI Last Update Date: | 10/03/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 23131 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |