MOUNTAIN MEDICAL GROUP LLC NPI 1104962067

NPI Information

  • NPI: 1104962067
  • Provider Name: MOUNTAIN MEDICAL GROUP LLC
  • Classification: Clinic/Center - 261QU0200X
  • Specialization: Urgent Care
  • Entity Type: Organization
  • Address: 1302 NE 3RD ST
    BEND, OR
    ZIP 97701
  • Phone: (541) 388-7799

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NPI Details

MOUNTAIN MEDICAL GROUP LLC is an urgent care clinic center in Bend, OR. MOUNTAIN MEDICAL GROUP LLC NPI is 1104962067. The provider is registered as an organization entity type.

The provider's business location address is:

1302 NE 3RD ST
BEND, OR
ZIP 97701-333
Phone: (541) 388-7799
Fax: (541) 389-4096

The provider's authorized official is Albert James Stone .
The authorized official title is Owner and has the following contact phone number (541) 317-0909.

The enumeration date for this NPI number is 1/29/2007 and was last updated on 12/4/2007.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QU0200XClinic/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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1R101956MEDICARE PINOREGON

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: 11/21/2025

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