Organization
COLUMBIACARE SERVICES INC
Active
Other names
Pony Creek Board and Care
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL SEWITSKY (FINANCE DIRECTOR)
(541) 858-8170
Entity
Organization
Contact information
Practice address
2345 MARION ST, NORTH BEND, OR 97459-2637
(541) 270-0219
Mailing address
3587 HEATHROW WAY, MEDFORD, OR 97504-4004
(541) 858-8170
(541) 858-8167
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Enumeration date
12/28/2017
Last updated
12/28/2017
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