Countryside Medical Llc

LBN: Countryside Medical Llc
Countryside Medical Llc is an health care organization with primary practice located at 2355 State St Ste 101 , Salem OR 97301-4541. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Countryside Medical Llc can be contacted via phone (503) 930-1854, or through Polzen, Natalie via phone (503) 930-1854.

Contact Information

Primary practice address
2355 State St Ste 101 Salem OR 97301-4541
Phone: (503) 930-1854
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Polzen, Natalie FNP-C
Phone: (503) 930-1854

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X

Profile Details

NPI number 1467205336
LBN Legal business name Countryside Medical Llc
DBA Doing business as
Authorized official Polzen, Natalie FNP-C
Entity Organization
Organization subpart 1 No
Enumeration date Apr 9th, 2024
Last updated Apr 9th, 2024 - about 7 months 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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