Organization
RCH HEP C PROGRAM
Active
Parent organization
ROGUE COMMUNITY HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
ROGUE COMMUNITY HEALTH
Authorized official
CALISA NORTH (CFO)
(541) 842-7642
Entity
Organization
Contact information
Practice address
900 E MAIN ST, MEDFORD, OR 97504-7136
(541) 842-7704
Mailing address
19 MYRTLE ST, MEDFORD, OR 97504-7337
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227698
—
OR
05
—
500667341
—
OR
Enumeration date
05/12/2017
Last updated
10/15/2020
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