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SOUTH SALEM IMMEDIATE CARE INC. NPI 1871648402


NPI Information

NPI: 1871648402
Provider Name: SOUTH SALEM IMMEDIATE CARE INC.

Doing Business As: DBA URGENT CARE CLINIC SOUTH

Classification: Clinic/Center - 261QU0200X
Entity Type: Organization

Specialization: Urgent Care

Address:
3777 COMMERCIAL ST SE
SALEM, OR
ZIP 97302
Phone: (503) 588-1234
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SOUTH SALEM IMMEDIATE CARE INC. is an urgent care clinic center in Salem, OR. SOUTH SALEM IMMEDIATE CARE INC. NPI is 1871648402. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Dba Urgent Care Clinic South.

The provider's business location address is:

3777 COMMERCIAL ST SE
SALEM, OR
ZIP 97302
Phone: (503) 588-1234
Fax: (503) 371-8662

The provider's authorized official is Rachel Maddy .
The authorized official title is President/owner and has the following contact phone number (503) 588-1234.

The enumeration date for this NPI number is 1/24/2007 and was last updated on 11/27/2018.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1173000000XLegal MedicineMD11684OREGONNo
2207Q00000XFamily MedicineNo
3207R00000XInternal MedicineNo
4261QU0200XClinic/CenterUrgent CareYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1130226MEDICAIDOREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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