Organization
COUNTY OF BAKER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY STATEN (DIRECTOR)
(541) 523-8211
Entity
Organization
Contact information
Practice address
2200 4TH ST, BAKER CITY, OR 97814-2615
(541) 523-8211
(541) 523-8242
Mailing address
2200 4TH ST, BAKER CITY, OR 97814-2615
(541) 523-8211
(541) 523-8242
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
OR
261QA0005X
Ambulatory Family Planning Facility
—
OR
261QP0905X
State or Local Public Health Clinic/Center
Primary
—
OR
291U00000X
Clinical Medical Laboratory
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
045315
—
OR
05
—
097410
—
OR
05
—
226312
—
OR
05
—
320390
—
OR
01
—
R166882
MEDICARE PTAN
OR
Enumeration date
08/31/2006
Last updated
07/21/2021
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