Organization
ROGUE COMMUNITY HEALTH
Active
Other names
Rogue Community Health Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
CALISA WARNKE (CFO)
(541) 842-7642
Entity
Organization
Contact information
Practice address
11160 HIGHWAY 62 STE A, EAGLE POINT, OR 97524-8025
(541) 773-3863
Mailing address
1000 E MAIN ST, MEDFORD, OR 97504-7667
(541) 773-3863
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227698
—
OR
Enumeration date
07/15/2021
Last updated
07/16/2021
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