Organization Name: | ROGUE COMMUNITY HEALTH |
NPI Number: | 1154753069 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WILLIAM D NORTH (CEO) |
Mailing Address: | 280 Mill Creek Dr Prospect |
State: | OR US |
Postal Code: | 975369722 |
Phone Number: | 5415601180 |
Fax Number: | 5415601194 |
NPI Enumeration Date: | 08/01/2013 |
NPI Last Update Date: | 08/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |