OrganizationLa Clinica Del Valle Family Health Care Center Inc(<Unavail>)Clinic/CenterAmbulatory Health Care FacilitiesPractice Address1307 W Main St, Medford, OR 97501-2936(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 4 days ago.Profile DetailsProvider ID1831492156Provider TypeOrganizationFull NameLa Clinica Del Valle Family Health Care Center IncOther Name<Unavail>SubpartYesEnumeration Date12/8/2010Last Updated7/15/2019Contact InformationPractice LocationPractice Address1307 W Main St, Medford, OR 97501-2936Phone(541) 535-6239Fax(541) 535-4377Mailing LocationMailing Address931 Chevy Way, Medford, OR 97504-4127Phone(541) 535-6239Fax(541) 842-2212Authorized OfficialNameJohnson, Brenda Irene (Ceo)Phone(541) 512-3151Provider TaxonomiesCodeDescriptionLicenseCode261QF0400XPrimaryDescriptionClinic/CenterAmbulatory Health Care FacilitiesLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID022868DescriptionMedicaidIssuerUnlistedOregon