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NPI Code Detail

MEDICARE: ROGUE COMMUNITY HEALTH

MEDICARE: ROGUE COMMUNITY HEALTH
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
1261QF0400XFederally Qualified Health Center (FQHC)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770645871
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROGUE COMMUNITY HEALTH
Provider Business Mailing Address
First Line : 8385 DIVISION ROAD
Second Line :
City : WHITE CITY
State : OR
Zip : 97503-1176
Country : US
Telephone Number : 541-826-5853
Fax Number : 541-826-5843
Provider Business Practice Location Address
First Line : 8385 DIVISION ROAD
Second Line :
City : WHITE CITY
State : OR
Zip : 97503-1176
Country : US
Telephone Number : 541-826-5853
Fax Number : 541-826-5843
Authorized Official
Title or Position : CFO
Name : CALISA N WARNKE
Credential :
Telephone Number : 541-842-7642
Provider Enumeration Date : 12/14/2006
Last Update Date : 10/15/2020

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Directions to “ROGUE COMMUNITY HEALTH ” Practice Location

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