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General NPI Number Information
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NPI Number | 1831070093
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Entity Type | Organization
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Legal Business Name | COQUILLE VALLEY HEALTH
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Dates
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Enumeration Date | 09/11/2025
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 940 E 5TH ST
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City | COQUILLE
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State | OR
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Zip | 97423-1666
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Country | US
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Telephone | 541-396-3101
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Fax | 541-824-1702
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Provider Business Mailing Address
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Address Line | 940 E 5TH ST
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City | COQUILLE
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State | OR
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Zip | 97423-1666
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Country | US
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Telephone | 541-396-3101
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Fax | 541-824-1702
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Authorized Official
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Title or Position | CEO
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Name | JEFFREY MICHAEL LANG
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Credential |
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Telephone | 541-396-3101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 275N00000X
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Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
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License Number |
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License Number State |
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