ICCO LLC NPI 1922458371

NPI Information

NPI: 1922458371
Provider Name: ICCO LLC

Doing Business As: HARRISBURG MEDICAL CLINIC

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

Specialization: Primary Care

CLIA Number: 38D2052017

Address:
420 SMITH ST
HARRISBURG, OR
ZIP 97446
Phone: (541) 995-5266
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ICCO LLC is a primary care clinic center in Harrisburg, OR. ICCO LLC NPI is 1922458371. The provider is registered as an organization entity type.
The provider Is Doing Business As Harrisburg Medical Clinic.

The provider's business location address is:

420 SMITH ST
HARRISBURG, OR
ZIP 97446
Phone: (541) 995-5266
Fax: (541) 995-5245

The provider's authorized official is Douglas D Bailey .
The authorized official title is Medical Director Harrisburg Clinic and has the following contact phone number (541) 998-6750.

The CLIA number assigned to this NPI record is 38D2052017 - other - fire district with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/16/2016 and was last updated on 6/13/2019.

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	261QU0200X	Clinic/Center	Urgent Care		OREGON	No
2	261QP2300X	Clinic/Center	Primary Care		OREGON	Yes

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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