ICCO LLC NPI 1235672478

NPI Information

NPI: 1235672478
Provider Name: ICCO LLC

Doing Business As: BESTMED

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
2710 WILLAMETTE STREET
EUGENE, OR
ZIP 97405
Phone: (541) 505-7317
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ICCO LLC is a primary care clinic center in Eugene, OR. ICCO LLC NPI is 1235672478. The provider is registered as an organization entity type.
The provider Is Doing Business As Bestmed.

The provider's business location address is:

2710 WILLAMETTE STREET
EUGENE, OR
ZIP 97405
Phone: (541) 505-7317
Fax: (541) 505-7486

The provider's authorized official is Erica Hauser .
The authorized official title is Cfo and has the following contact phone number (312) 590-5372.

The CLIA number assigned to this NPI record is 38D2100148 - other - urgent/primary care with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/21/2016 and was last updated on 6/20/2022.

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
1	261QP2300X	Clinic/Center	Primary Care			Yes

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
1	DP1360	OTHER	OREGON	RR MEDICARE PTAN

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: 5/5/2024

NPI Synchronization or Removal

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