ICCO LLC NPI 1639612880

NPI Information

NPI: 1639612880
Provider Name: ICCO LLC

Doing Business As: PRIME CARE PARTNERS

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
5781 MAIN STREET
SPRINGFIELD, OR
ZIP 97478
Phone: (541) 654-5245
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ICCO LLC is a primary care clinic center in Springfield, OR. ICCO LLC NPI is 1639612880. The provider is registered as an organization entity type.
The provider Is Doing Business As Prime Care Partners.

The provider's business location address is:

5781 MAIN STREET
SPRINGFIELD, OR
ZIP 97478
Phone: (541) 654-5245
Fax: (541) 844-1801

The provider's authorized official is Peggy J Anderson .
The authorized official title is Billing Office Manager and has the following contact phone number (541) 228-3865.

The enumeration date for this NPI number is 11/21/2016 and was last updated on 11/21/2016.

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	261QP2300X	Clinic/Center	Primary Care			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	DP1360	OTHER	OREGON	RR MEDICARE PTAN
2	R145612	MEDICARE PIN	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

NPI Synchronization or Removal

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