Organization
UMPQUA COMMUNITY HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KC BOLTON (CEO)
(541) 672-9596
Entity
Organization
Contact information
Practice address
775 TAYLOR ST., SUTHERLIN, OR 97479
(541) 672-9596
Mailing address
150 NE KENNETH FORD DR, ROSEBURG, OR 97470-1042
(541) 672-9596
(541) 464-3519
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
01/07/2014
Last updated
01/02/2024
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