Provider Demographics
NPI:1003891581
Name:SHEILA M MAURER
Entity Type:Organization
Organization Name:SHEILA M MAURER
Other - Org Name:ROGUE RIVER HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:MAURER
Authorized Official - Suffix:JR
Authorized Official - Credentials:EDD
Authorized Official - Phone:541-582-8899
Mailing Address - Street 1:216 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROGUE RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97537-9416
Mailing Address - Country:US
Mailing Address - Phone:541-582-8899
Mailing Address - Fax:
Practice Address - Street 1:216 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ROGUE RIVER
Practice Address - State:OR
Practice Address - Zip Code:97537-9416
Practice Address - Country:US
Practice Address - Phone:541-582-8899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-07
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR268718Medicaid
383829Medicare Oscar/Certification