NPI:
1376646380
Provider Name:
COUNTY OF LAKE
Doing Business As: LAKE COUNTY PUBLIC HEALTH
Classification:
Clinic/Center - 261QP0905X
Entity Type:
Organization
Specialization: Public Health, State or Local
CLIA Number: 38D0664024
Address:
100 N D ST
SUITE 100
LAKEVIEW, OR
ZIP 97630
Phone:
(541) 947-6045
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COUNTY OF LAKE is a public health and state or local clinic center in Lakeview, OR. COUNTY OF LAKE NPI is 1376646380. The provider is registered as an organization entity type.
The provider Is Doing Business As Lake County Public Health.
The provider's business location address is:
100 N D ST
SUITE 100
LAKEVIEW, OR
ZIP 97630-540
Phone: (541) 947-6045
Fax: (541) 947-4563
The provider's authorized official is Mary L Wilkie .
The authorized official title is Administrator and has the following contact phone number (541) 947-6045.
The CLIA number assigned to this NPI record is 38D0664024 - other with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 9/6/2006 and was last updated on 7/21/2022.