ICCO LLC NPI 1750492906

NPI Information

  • NPI: 1750492906
  • Provider Name: ICCO LLC
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • Doing Business As: COTTAGE GROVE URGENT CARE
  • CLIA Number: 53D2258046
  • Address: 1445 GATEWAY BLVD
    COTTAGE GROVE, OR
    ZIP 97424
  • Phone: (541) 942-7000

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NPI Details

ICCO LLC is a clinic center in Cottage Grove, OR. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). ICCO LLC NPI is 1750492906. The provider is registered as an organization entity type.
The provider Is Doing Business As Cottage Grove Urgent Care.

The provider's business location address is:

1445 GATEWAY BLVD
COTTAGE GROVE, OR
ZIP 97424-224
Phone: (541) 942-7000
Fax: (541) 942-5550

The provider's authorized official is Alexander K Morley .
The authorized official title is Medical Director and has the following contact phone number (541) 641-6053.

The CLIA number assigned to this NPI record is 53D2258046 - other - urgent care with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 6/16/2018.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterPA00462OREGONNo
2261Q00000XClinic/CenterMD10106OREGONNo
3261Q00000XClinic/CenterPA01017OREGONNo
4261Q00000XClinic/CenterMD25942OREGONYes

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
106691900OTHEROREGONBLUE CROSS/BLUE SHIELD
2150890MEDICAIDOREGON

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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