OrganizationLa Clinica Del Valle Family Health Care Center Inc.(<Unavail>)Clinic/CenterAmbulatory Health Care FacilitiesPractice Address713 Summit Avenue, Medford, OR 97501(541) 842-3771(541) 535-6239PECOS EnrollmentBased on the most recent information from CMS, provider La Clinica Del Valle Family Health Care Center Inc. does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1497090971Provider TypeOrganizationFull NameLa Clinica Del Valle Family Health Care Center Inc.Other Name<Unavail>SubpartYesEnumeration Date12/10/2012Last Updated7/15/2019Contact InformationPractice LocationPractice Address713 Summit Avenue, Medford, OR 97501Phone(541) 842-3771Fax(541) 842-3084Mailing LocationMailing Address931 Chevy Way, Medford, OR 97504-4127Phone(541) 535-6239Fax(541) 842-2212Authorized OfficialNameJeannot, Tara Lynette (Chief Operations Officer)Phone(541) 535-6239Provider TaxonomiesCodeDescriptionLicenseCode261QF0400XPrimaryDescriptionClinic/CenterAmbulatory Health Care FacilitiesLicenseUnlisted IssuerOregonProvider IdentifiersIDDescriptionIssuerID022868DescriptionMedicaidIssuerUnlistedOregon