Organization Name: | VERDURA FAMILY WELLNESS, INC |
NPI Number: | 1346507746 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SARA MILLER (PRACTICE MANAGER) |
Mailing Address: | 348 S Pine St Carlton |
State: | OR US |
Postal Code: | 971111228 |
Phone Number: | 5036488210 |
Fax Number: | 5036488283 |
NPI Enumeration Date: | 04/23/2012 |
NPI Last Update Date: | 04/23/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |