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General NPI Number Information
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NPI Number | 1285819094
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Entity Type | Organization
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Legal Business Name | WILLAMETTE COMMUNITY MEDICAL GROUP
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Dates
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Enumeration Date | 12/31/2007
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Last Update Date | 02/17/2009
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Provider Practice Location Address
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Address Line | 5781 MAIN ST
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City | SPRINGFIELD
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State | OR
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Zip | 97478-5426
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Country | US
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Telephone | 541-284-1694
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Fax | 541-242-4760
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Provider Business Mailing Address
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Address Line | 4000 MERIDIAN BLVD ATTN: DEBBIE BREWER
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City | FRANKLIN
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State | TN
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Zip | 37067-6325
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Country | US
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Telephone | 615-465-7626
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Fax | 615-465-3007
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Authorized Official
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Title or Position | DIRECTOR
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Name | DEBBIE BREWER
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Credential |
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Telephone | 615-465-7262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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