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General NPI Number Information
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NPI Number | 1215372347
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTH CENTERS OF LANE COUNTY
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Dates
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Enumeration Date | 05/02/2013
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Last Update Date | 05/02/2013
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Provider Practice Location Address
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Address Line | 2073 OLYMPIC ST
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City | SPRINGFIELD
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State | OR
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Zip | 97477-3413
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Country | US
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Telephone | 541-682-3530
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Fax |
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Provider Business Mailing Address
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Address Line | 2073 OLYMPIC ST
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City | SPRINGFIELD
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State | OR
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Zip | 97477-3413
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Country | US
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Telephone | 541-682-3530
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Fax |
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Authorized Official
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Title or Position | PRIMARY CARE NURSING SUPERVISOR
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Name | ANDREA SINGH
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Credential |
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Telephone | 541-682-3530
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 201230517LPN
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License Number State | OR
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