Organization
MOSAIC MEDICAL MOBILE UNIT
Active
Parent organization
MOSAIC MEDICAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
MOSAIC MEDICAL
Authorized official
MEGAN HAASE FNP (CEO)
(541) 447-0707
Entity
Organization
Contact information
Practice address
2084 NE PROFESSIONAL CT, BEND, OR 97701-6077
(541) 383-3005
(541) 383-1883
Mailing address
375 NW BEAVER ST, SUITE 101, PRINEVILLE, OR 97754-1802
(541) 447-0707
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182960
—
OR
Enumeration date
01/22/2013
Last updated
06/30/2015
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