UMPQUA COMMUNITY HEALTH CENTER INC. NPI 1396751772

NPI Information

NPI: 1396751772
Provider Name: UMPQUA COMMUNITY HEALTH CENTER, INC.
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 38D0867765

Address:
150 KENNETH FORD DR
ROSEBURG, OR
ZIP 97470
Phone: (541) 672-9596
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UMPQUA COMMUNITY HEALTH CENTER, INC. is a federally qualified health center (fqhc) clinic center in Roseburg, OR. UMPQUA COMMUNITY HEALTH CENTER, INC. NPI is 1396751772. The provider is registered as an organization entity type.

The provider's business location address is:

150 KENNETH FORD DR
ROSEBURG, OR
ZIP 97470-042
Phone: (541) 672-9596
Fax: (541) 464-3519

The provider's authorized official is Kc Bolton .
The authorized official title is Ceo and has the following contact phone number (541) 672-9596.

The CLIA number assigned to this NPI record is 38D0867765 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/31/2006 and was last updated on 6/28/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	168395	MEDICAID	OREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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