Organization Name: | PEACEHEALTH MEDICAL GROUP COTTAGE GROVE |
NPI Number: | 1780631267 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WENDY APLAND (CFO) |
Mailing Address: | 98 W Oregon Ave Creswell |
State: | OR US |
Postal Code: | 974269259 |
Phone Number: | 5412227700 |
Fax Number: | |
NPI Enumeration Date: | 05/28/2006 |
NPI Last Update Date: | 06/04/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM1300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Multi-Specialty |
Taxonomy Definition: |