Provider Demographics
NPI:1417279548
Name:MONARCH MEDICAL GROUP LLC
Entity Type:Organization
Organization Name:MONARCH MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAMBERLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-465-3966
Mailing Address - Street 1:363 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2309
Mailing Address - Country:US
Mailing Address - Phone:541-465-3966
Mailing Address - Fax:541-465-3967
Practice Address - Street 1:637 HICKORY ST NW STE 160
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-1761
Practice Address - Country:US
Practice Address - Phone:541-497-7728
Practice Address - Fax:541-465-3967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-16
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center