Icco Llc is a Clinic/center in Oakridge, Oregon. Icco Llc practices all healthcare services and medical treatments related to Clinic/center. The NPI Number for Icco Llc is 1205990041. The last update date is 2019-07-16.
Icco Llc's current location address is 48134 Hwy 58, Oakridge, Oregon. You can contact this provider via phone number 5417824068 and fax number 5417824113. The mailing address for Icco Llc is 48134 Hwy 58, Oakridge, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Icco Llc |
|---|---|
| Address | 48134 Hwy 58, Oakridge, Oregon |
| Phone Number | 5417824068 |
| Fax Number | 5417824113 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | MEDICAL DI |
|---|---|
| Authorized Official Name | Bailey Douglas |
| Credentials | M.D. |
| Telephone Number | 5417824068 |
NPI Number Detail
| NPI Number | 1205990041 |
|---|---|
| Provider Enumeration Date | 2006-12-19 |
| Last Updated Date | 2019-07-16 |
Provider Mailing Address Detail
| Address | 48134 Hwy 58 |
|---|---|
| City | Oakridge |
| State | Oregon (OR) |
| Post Code | 97463 |
| Phone Number | 5417824068 |
| Fax Number | 5417824113 |
Provider's Primary Taxonomy Detail
| Speciality | Clinic/center |
|---|---|
| Taxonomy | 261Q00000X |
| Licence No | 8928878 |
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Definition: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g |
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What is the unique identification code assigned to Icco Llc by the Centers for Medicare & Medicaid Services?
The Icco Llc has been issued the NPI (National Provider Identifier) 1205990041. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Icco Llc's physical address?
The Icco Llc is physically located at 48134 Hwy 58, in the city of Oakridge, OR, with the postal code 97463.
What is Icco Llc's area of expertise and its corresponding taxonomy classification?
The Icco Llc's field of specialization is Clinic/center, and it falls under the taxonomy code 261Q00000X, which categorizes healthcare providers based on their areas of practice.
On what date did the Icco Llc receive the assignment of its 1205990041 from the Centers for Medicare & Medicaid Services?
The Icco Llc was issued its 1205990041 by the Centers for Medicare & Medicaid Services on 2006-12-19.
As of what date was the information regarding Icco Llc, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Icco Llc, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2019-07-16.