Provider Demographics
NPI:1932621141
Name:MCMINNVILLE IMMEDIATE HEALTH CARE LLC
Entity Type:Organization
Organization Name:MCMINNVILLE IMMEDIATE HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-844-9800
Mailing Address - Street 1:207 NE 19TH ST
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-9927
Mailing Address - Country:US
Mailing Address - Phone:503-435-1077
Mailing Address - Fax:615-844-9883
Practice Address - Street 1:207 NE 19TH ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-9927
Practice Address - Country:US
Practice Address - Phone:503-435-1077
Practice Address - Fax:615-844-9883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty