PEACEHEALTH NPI 1760704878

NPI Information

NPI: 1760704878
Provider Name: PEACEHEALTH

Doing Business As: PEACEHEALTH MEDICAL GROUP-DEXTER

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
38843 DEXTER RD
DEXTER, OR
ZIP 97431
Phone: (541) 937-2134
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PEACEHEALTH is a rural health clinic center in Dexter, OR. PEACEHEALTH NPI is 1760704878. The provider is registered as an organization entity type.
The provider Is Doing Business As Peacehealth Medical Group-dexter.

The provider's business location address is:

38843 DEXTER RD
DEXTER, OR
ZIP 97431-110
Phone: (541) 937-2134

The provider's authorized official is Wendy Apland .
The authorized official title is Cfo and has the following contact phone number (541) 686-3968.

The CLIA number assigned to this NPI record is 38D0627103 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/17/2010 and was last updated on 9/10/2010.

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	261QR1300X	Clinic/Center	Rural Health			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	38 3808	OTHER		MEDICARE PART A PTAN

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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