La Clinica Del Valle Family Health Care Center Inc.

(<Unavail>)

Clinic/Center

Ambulatory Health Care Facilities

221 W Stewart Ave, Medford, OR 97501-3609

PECOS Enrollment

Based 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 B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1679896278
Provider Type
Organization
Full Name
La Clinica Del Valle Family Health Care Center Inc.
Other Name
<Unavail>

Subpart
No
Enumeration Date
3/10/2010
Last Updated
5/24/2019

Contact Information

Practice Location

221 W Stewart Ave, Medford, OR 97501-3609

(541) 690-3500

Unlisted Fax

Mailing Location

931 Chevy Way, Medford, OR 97504-4127

(541) 535-6239

(541) 842-2212

Authorized Official

Johnson, Brenda Irene (Ceo)

(541) 512-3151

Provider Taxonomies

Code	Description	License
Code 261QF0400X Primary	Description Clinic/Center Ambulatory Health Care Facilities	License Unlisted Issuer