Provider Demographics
NPI:1861703126
Name:ELGIN HEALTH CENTER LLC
Entity type:Organization
Organization Name:ELGIN HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TEMPIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTELL
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:541-437-0239
Mailing Address - Street 1:PO BOX 908
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:OR
Mailing Address - Zip Code:97827-0908
Mailing Address - Country:US
Mailing Address - Phone:541-437-0239
Mailing Address - Fax:
Practice Address - Street 1:720 ALBANY ST
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:OR
Practice Address - Zip Code:97827
Practice Address - Country:US
Practice Address - Phone:541-437-0239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-01
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200050027NP-FNP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty