Willamette Community Medical Group, LLC
NPI #1104062371 in Springfield, Oregon
Provider Information
- NPI Number
- 1104062371
- Entity Type
- Organization
- Organization Name
- Willamette Community Medical Group, LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- MEDVANTX, INC.
- Primary Specialty
- Non-Pharmacy Dispensing Site
- Enumeration Date
- Dec 18, 2008
- Last Updated
- Dec 18, 2008
Practice Location
- Address
- 5781 MAIN ST
- City
- Springfield
- State
- Oregon
- ZIP Code
- 97478-5426
- Phone
- (541) 284-1694
Authorized Official
- Name
- KENNY HEINE
- Title
- DIRECTOR OF OPERATIONS
- Phone
- (858) 625-2990
Specialties & Taxonomy Codes
| Specialty |
|---|
| Non-Pharmacy Dispensing Site |
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