Healthcare Provider Details

I. General information

NPI: 1811569387
Provider Name (Legal Business Name): NEHALEM BAY HEALTH CENTER AND PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2021
Last Update Date: 01/10/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24705 HIGHWAY 101 N
ROCKAWAY BEACH OR
97136-9893
US

IV. Provider business mailing address

PO BOX 176
WHEELER OR
97147-0176
US

V. Phone/Fax

Practice location:
  • Phone: 800-368-5182
  • Fax:
Mailing address:
  • Phone: 800-368-5182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number StateNULL

VIII. Authorized Official

Name: GALE NELSON
Title or Position: CEO
Credential:
Phone: 800-368-5182