Evergreen Family Medicine South

LBN: Centennial Medical Group East, Llc
Evergreen Family Medicine South is an health care organization with primary practice located at 145 Ne Broadway St , Myrtle Creek OR 97457-9039. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Rural Health. Ambulatory Health Care Facilities / Rural Health is the primary health care specialty. Centennial Medical Group East, Llc can be contacted via phone (541) 863-3146, or through Tyree, Kim via phone (541) 229-3332.

Contact Information

Primary practice address
145 Ne Broadway St Myrtle Creek OR 97457-9039
Phone: (541) 863-3146
Fax: (541) 863-3226
Website:
Map and Directions
Authorized official contact:
Name: Tyree, Kim
Phone: (541) 229-3332

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 71216890 Oregon
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X Oregon
Ambulatory Health Care Facilities / Rural Health 261QR1300X Oregon

Profile Details

NPI number 1699103598
LBN Legal business name Centennial Medical Group East, Llc
DBA Doing business as Evergreen Family Medicine South
Authorized official Tyree, Kim
Entity Organization
Organization subpart 1 Yes
Enumeration date Oct 31st, 2013
Last updated Nov 22nd, 2016 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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