Phoenix Rising Family Medicine Llc

LBN: Phoenix Rising Family Medicine Llc
Phoenix Rising Family Medicine Llc is an health care organization with primary practice located at 810 Commercial St Se , Salem OR 97302. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Phoenix Rising Family Medicine Llc can be contacted via phone (971) 227-1073, or through Dupuis, Joel E via phone (541) 556-6743.

Contact Information

Primary practice address
810 Commercial St Se Salem OR 97302
Phone: (971) 227-1073
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Dupuis, Joel E
Phone: (541) 556-6743

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X 201505391NP-PP Oregon

Profile Details

NPI number 1033654793
LBN Legal business name Phoenix Rising Family Medicine Llc
DBA Doing business as
Authorized official Dupuis, Joel E
Entity Organization
Organization subpart 1 No
Enumeration date Jan 4th, 2017
Last updated Jul 31st, 2018 - about 6 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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Identifiers

StateTypeNumberIssuer
All States NPI 1033654793 NPPES
Oregon MEDICAID 500690272
Oregon Other R185124

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