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General NPI Number Information
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NPI Number | 1790914117
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Entity Type | Organization
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Legal Business Name | SOUTH COUNTY HEALTH DISTRICT
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Dates
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Enumeration Date | 07/07/2009
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Last Update Date | 10/17/2022
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Provider Practice Location Address
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Address Line | 142 E. DEARBORN
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City | UNION
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State | OR
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Zip | 97883-0986
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Country | US
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Telephone | 541-562-2222
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Fax | 541-562-2224
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Provider Business Mailing Address
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Address Line | PO BOX 993
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City | UNION
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State | OR
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Zip | 97883-0993
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Country | US
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Telephone | 541-562-2222
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Fax | 541-562-2224
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Authorized Official
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Title or Position | OFFICE MANAGER/ DIRECTOR
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Name | ADINA FERGUSON
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Credential |
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Telephone | 541-562-2222
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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 |
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 383830
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License Number State | OR
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