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South Coast Healthcare Llc
Family Nurse Practitioner in Gold Beach, Oregon
NPI 1134740152

South Coast Healthcare Llc is a Family Nurse Practitioner based in Gold Beach, OR and is specialized in Family. South Coast Healthcare Llc practices in Gold Beach, OR. The NPI Number for South Coast Healthcare Llc is 1134740152 and holds a License No. (Oregon).

The current practice location address for South Coast Healthcare Llc is 29641 Ellensburg Ave, Gold Beach, OR and can be reached out via phone at 541-698-8080.

Location: 29641 Ellensburg Ave, Gold Beach, OR, 97444-8701
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1134740152
Provider Name
South Coast Healthcare Llc
Credential
Provider Entity Type
Organization
Address
29641 Ellensburg Ave, Gold Beach, OR, 97444-8701
Phone Number
541-698-8080
Fax Number
Provider Enumeration Date
04/30/2020
Last Update Date
03/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
500783924 05 OR
institution
Provider Business Practice Location Address Details
Address
29641 Ellensburg Ave
City
Gold Beach
State
Oregon
Zip
97444-8701
Phone Number
541-698-8080
Fax Number
person
Provider Business Mailing Address Details
Address
29641 Ellensburg Ave
City
Gold Beach
State
Oregon
Zip
97444-8701
Phone Number
541-698-8080
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
261QP2300X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
()
Definition
Definition to come...
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