MT. TABOR FAMILY MEDICAL GROUP P.C. NPI 1548416944

NPI Information

MT. TABOR FAMILY MEDICAL GROUP, P.C. is a non pharmacy dispensing site in Portland, OR. The provider is a site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) MT. TABOR FAMILY MEDICAL GROUP, P.C. NPI is 1548416944. The provider is registered as an organization entity type.

The provider's business location address is:

5919 SE BELMONT ST
PORTLAND, OR
ZIP 97215-925
Phone: (503) 234-7366

The provider's authorized official is Kenny Heine .
The authorized official title is Director Of Operations and has the following contact phone number (858) 625-2990.

The enumeration date for this NPI number is 8/18/2008 and was last updated on 7/2/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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