PINE EAGLE HEALTH PLANNING COMMITTEE NPI 1922102128

NPI Information

NPI: 1922102128
Provider Name: PINE EAGLE HEALTH PLANNING COMMITTEE

Doing Business As: DBA-PINE EAGLE CLINIC

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
218 NORTH PINE STREET
HALFWAY, OR
ZIP 97834
Phone: (541) 742-5023
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PINE EAGLE HEALTH PLANNING COMMITTEE is a rural health clinic center in Halfway, OR. PINE EAGLE HEALTH PLANNING COMMITTEE NPI is 1922102128. The provider is registered as an organization entity type.
The provider Is Doing Business As Dba-pine Eagle Clinic.

The provider's business location address is:

218 NORTH PINE STREET
HALFWAY, OR
ZIP 97834
Phone: (541) 742-5023
Fax: (541) 742-7210

The provider's authorized official is Terra Jean Lewis .
The authorized official title is Administrator and has the following contact phone number (541) 742-5024.

The CLIA number assigned to this NPI record is 38D0860602 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/11/2006 and was last updated on 6/17/2020.

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	261QR1300X	Clinic/Center	Rural Health	383869	OREGON	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	R139059	OTHER	OREGON	MEDICARE B
2	009919000	OTHER	OREGON	BLUE CROSS BLUE SHIELD
3	025069	MEDICAID	OREGON

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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