Wild Rose Medical Clinic Pc

LBN: Wild Rose Medical Clinic Pc
Wild Rose Medical Clinic Pc is an health care organization with primary practice located at 401 E 10Th Ave Suite 250, Eugene OR 97401-3317. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Wild Rose Medical Clinic Pc can be contacted via phone (541) 686-4153, or through Cordes, Kathleen via phone (541) 686-4153.

Contact Information

Primary practice address
401 E 10Th Ave Suite 250 Eugene OR 97401-3317
Phone: (541) 686-4153
Fax: (541) 686-3468
Website:
Map and Directions
Authorized official contact:
Name: Cordes, Kathleen Doctor of Medicine (MD)
Phone: (541) 686-4153

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 16009 Oregon

Profile Details

NPI number 1083762637
LBN Legal business name Wild Rose Medical Clinic Pc
DBA Doing business as
Authorized official Cordes, Kathleen Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 8th, 2007
Last updated Oct 10th, 2007 - about 19 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083762637 NPPES
Oregon MEDICAID 072173

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