Waterfall Clinic, Incorporated

LBN: Waterfall Clinic, Incorporated
Waterfall Clinic, Incorporated is an health care organization with primary practice located at 826 S 11Th St , Coos Bay OR 97420. The organization recently has only one registered license in Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), which is considered as the primary health care specialty. Waterfall Clinic, Incorporated can be contacted via phone (541) 756-6232, or through Mcferon, Ava Kathleen via phone (541) 435-7033.

Contact Information

Primary practice address
826 S 11Th St Coos Bay OR 97420
Phone: (541) 756-6232
Fax: (541) 756-6234
Website:
Map and Directions
Authorized official contact:
Name: Mcferon, Ava Kathleen
Phone: (541) 435-7033

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X

Profile Details

NPI number 1508133299
LBN Legal business name Waterfall Clinic, Incorporated
DBA Doing business as
Authorized official Mcferon, Ava Kathleen
Entity Organization
Organization subpart 1 Yes
Enumeration date Nov 23rd, 2011
Last updated Feb 26th, 2018 - about 7 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 1508133299 NPPES
Oregon MEDICAID 500647633

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