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NPI Code Detail

MEDICARE: KLAMATH HEALTH PARTNERSHIP INC

MEDICARE: KLAMATH HEALTH PARTNERSHIP INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QF0400XFederally Qualified Health Center (FQHC)102910OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538155825
Entity Type Code : Organization
Provider Name (Legal Business Name) : KLAMATH HEALTH PARTNERSHIP INC
Provider Business Mailing Address
First Line : 2074 SOUTH 6TH STREET
Second Line :
City : KLAMATH FALLS
State : OR
Zip : 97601-3372
Country : US
Telephone Number : 541-851-8110
Fax Number : 541-880-2070
Provider Business Practice Location Address
First Line : 2074 SOUTH 6TH STREET
Second Line :
City : KLAMATH FALLS
State : OR
Zip : 97601-3372
Country : US
Telephone Number : 541-851-8110
Fax Number : 541-880-2070
Authorized Official
Title or Position : CEO
Name : MRS. SIGNE PORTER
Credential :
Telephone Number : 541-851-8110
Provider Enumeration Date : 09/22/2005
Last Update Date : 08/06/2020

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Directions to “KLAMATH HEALTH PARTNERSHIP INC ” Practice Location

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