Bandon Community Health Ctr
Clinic/Center, Federally Qualified Health Center (FQHC) in Port Orford, OR. Organization (NPI-2).
NPI number1013587484
StatusActive
Last updated in NPPESJun 29, 2021
Details
- NPI
- 1013587484
- Entity type
- Organization (NPI-2)
- Legal business name
- Bandon Community Health Ctr
- Organization subpart
- Yes
- Enumeration date
- Jun 29, 2021
- Certification date
- Jun 8, 2021
- Last updated
- Jun 29, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QF0400X | Clinic/Center, Federally Qualified Health Center (FQHC) | – | – | Yes |
Other names
- Coast Community Health Center (Doing Business As)
Practice location
312 Tichenor StPort Orford, OR 97465-8672
Phone 541-347-2529 · Fax 541-347-9196
Mailing address
1010 1st St Se Ste 110Bandon, OR 97411-9301
Phone 541-347-2529 · Fax 541-347-9196
Authorized official
Linda S Maxon
Ceo
5413472529
Is something wrong?
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