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Icco Llc
Clinic/Center in Cottage Grove, Oregon
NPI 1750492906

Icco Llc is a Clinic/Center based in Eugene, OR. Icco Llc practices in Cottage Grove, OR. The NPI Number for Icco Llc is 1750492906 and holds a License No. MD25942 (Oregon).

The current practice location address for Icco Llc is 1445 Gateway Blvd, Cottage Grove, OR and can be reached out via phone at 541-942-7000 and via fax at 541-942-5550.

Location: 1445 Gateway Blvd, Cottage Grove, OR, 97401
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1750492906
Provider Name
Icco Llc
Credential
Provider Entity Type
Organization
Address
1445 Gateway Blvd, Cottage Grove, OR, 97401
Phone Number
541-942-7000
Fax Number
541-942-5550
Provider Enumeration Date
08/31/2006
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
150890 05 OR
06691900 01 OR BLUE CROSS/BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
1445 Gateway Blvd
City
Cottage Grove
State
Oregon
Zip
97424-1224
Phone Number
541-942-7000
Fax Number
541-942-5550
person
Provider Business Mailing Address Details
Address
1445 Gateway Blvd
City
Cottage Grove
State
Oregon
Zip
97424-1224
Phone Number
541-942-7000
Fax Number
541-942-5550
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
MD25942 (Oregon)
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
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