Provider Demographics
NPI:1568546570
Name:NEHALEM BAY HEALTH CENTER AND PHARMACY
Entity Type:Organization
Organization Name:NEHALEM BAY HEALTH CENTER AND PHARMACY
Other - Org Name:THE RINEHART CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-368-5182
Mailing Address - Street 1:P.O. BOX 176
Mailing Address - Street 2:
Mailing Address - City:WHEELER
Mailing Address - State:OR
Mailing Address - Zip Code:97147-0176
Mailing Address - Country:US
Mailing Address - Phone:503-368-5182
Mailing Address - Fax:503-368-7328
Practice Address - Street 1:230 ROWE STREET
Practice Address - Street 2:
Practice Address - City:WHEELER
Practice Address - State:OR
Practice Address - Zip Code:97147-0176
Practice Address - Country:US
Practice Address - Phone:503-368-5182
Practice Address - Fax:503-368-7328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR136296261QF0400X
261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR136296Medicaid
102124Medicare UPIN
383826AMedicare Oscar/Certification
OR136296Medicaid