Provider Demographics
NPI:1811569387
Name:NEHALEM BAY HEALTH CENTER AND PHARMACY
Entity Type:Organization
Organization Name:NEHALEM BAY HEALTH CENTER AND PHARMACY
Other - Org Name:NKN STUDENT HEALTH & WELLNESS
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GALE
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:PO 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:800-368-5182
Mailing Address - Fax:
Practice Address - Street 1:24705 HIGHWAY 101 N
Practice Address - Street 2:
Practice Address - City:ROCKAWAY BEACH
Practice Address - State:OR
Practice Address - Zip Code:97136-9893
Practice Address - Country:US
Practice Address - Phone:800-368-5182
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEHALEM BAY HEALTH CENTER AND PHARMACY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-14
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
No305S00000XManaged Care OrganizationsPoint of Service