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General NPI Number Information
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NPI Number | 1326589771
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Entity Type | Organization
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Legal Business Name | SAINT MOSCATI COMMUNITY HEALTH CARE
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Dates
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Enumeration Date | 03/18/2017
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Last Update Date | 04/04/2024
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Provider Practice Location Address
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Address Line | 1880 LANCASTER DR NE STE 104
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City | SALEM
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State | OR
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Zip | 97305-1040
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Country | US
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Telephone | 971-273-0679
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Fax | 503-961-0794
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Provider Business Mailing Address
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Address Line | 1880 LANCASTER DR NE STE 104
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City | SALEM
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State | OR
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Zip | 97305-1040
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Country | US
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Telephone | 971-273-0679
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Fax | 503-961-0794
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Authorized Official
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Title or Position | ADMINISTRATIVE ASSISTANT
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Name | CLARA CASTILLO
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Credential |
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Telephone | 971-273-0679
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 201600993NP-PP
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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