Organization
BENTON COUNTY
Active
Parent organization
BENTON COUNTY
Other names
Benton County Health Services, Benton County Health Services - Benton Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
BENTON COUNTY
Authorized official
LACEY MOLLEL (HEALTH CENTER DIRECTOR)
(541) 766-6835
Entity
Organization
Contact information
Practice address
530 NW 27TH ST, CORVALLIS, OR 97330-5223
(541) 766-6835
(541) 766-6164
Mailing address
PO BOX 579, CORVALLIS, OR 97339-0579
(541) 766-6835
(541) 766-6164
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
227701
OR
3336C0002X
Clinic Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
039328000
REGENCE BCBS
—
05
—
043047
—
OR
05
—
227701
—
OR
01
—
3845053
NCPDP
OR
01
—
700228501
REGENCE BCBS
—
01
—
RP-0002882-CS
OR PHARMACY LICENSE
OR
01
—
RP0002882CS
LICENSE
OR
Enumeration date
04/03/2006
Last updated
04/29/2026
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