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NPI Code Detail

MEDICARE: MCCRAE MANAGEMENT & INVESTMENT, LTD

MEDICARE: MCCRAE MANAGEMENT & INVESTMENT, LTD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332S00000XHearing Aid Equipment

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3243241700OTHEROWCP
454627OTHERWAWA LABOR & INDUSTRIES

General Provider Information

NPI Number : 1679583660
Entity Type Code : Organization
Provider Name (Legal Business Name) : MCCRAE MANAGEMENT & INVESTMENT, LTD
Provider Business Mailing Address
First Line : 26222 RANCH ROAD 12
Second Line :
City : DRIPPING SPRINGS
State : TX
Zip : 78620-4903
Country : US
Telephone Number : 512-858-5030
Fax Number : 512-858-2714
Provider Business Practice Location Address
First Line : 1939 E BURNSIDE ST
Second Line :
City : PORTLAND
State : OR
Zip : 97214-1535
Country : US
Telephone Number : 503-233-6141
Fax Number : 503-233-2889
Authorized Official
Title or Position : CREDENTIALING/CONTRACTING SPECIALIS
Name : MS. ELISE DOMINEY
Credential :
Telephone Number : 512-858-0300
Provider Enumeration Date : 08/09/2006
Last Update Date : 01/30/2014

Similar Medicare Providers

1912037375 — MR. SCOTT L AUSTIN BC-HIS
Practice Location Address:
1939 E BURNSIDE ST
PORTLAND, OR
97214-1535
Practice Phone: 503-233-6141
Practice Fax: 503-233-2889
1720118151 — MS. CHRISTINE JANE MOULTON M.S., CCC-A
Practice Location Address:
1939 E BURNSIDE ST
PORTLAND, OR
97214-1535
Practice Phone: 503-233-6141
Practice Fax: 503-233-2889
1811027196 — MR. ROBERT A KLEIN BC-HIS
Practice Location Address:
1939 E BURNSIDE ST
PORTLAND, OR
97214-1535
Practice Phone: 503-233-6141
Practice Fax: 503-233-2889
1164552998 — MR. KELLY MCCORMICK BC-HIS
Practice Location Address:
1939 E BURNSIDE ST
PORTLAND, OR
97214-1535
Practice Phone: 503-233-6141
Practice Fax: 503-233-2889
1609991256 — MR. CHARLES INMAN BC-HIS
Practice Location Address:
1939 E BURNSIDE ST
PORTLAND, OR
97214-1535
Practice Phone: 503-233-6141
Practice Fax: 503-233-2889
1962672543 — JESSICA ZABALDO
Practice Location Address:
1939 E BURNSIDE ST
PORTLAND, OR
97214-1535
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Practice Fax:

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