WATERFALL COMMUNITY HEALTH CENTER (NPI# 1730564386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730564386 |
| Entity Type | Organization |
| Organization Name | WATERFALL COMMUNITY HEALTH CENTER |
| Other Organization Name | WATERFALL COMMUNITY PHARMACY |
| Practice Address |
2299 Butte Falls Hwy Eagle Point OR 97524-4463 |
| Practice Telephone | 5419517723 |
| Mailing Telephone | 5419517723 |
| Enumeration Date | 2015-07-24 |
| Last Update Date | 2017-07-11 |
| Authorized Official Name | MRS. ANDREA TRENNER (CEO) |
| Authorized Official Telephone | 5417566232 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
7062 | OR | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Waterfall Community Pharmacy | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | WATERFALL COMMUNITY HEALTH CENTER | 1890 Waite St Ste 1, North Bend, OR 97459-1229 |
| Street Address |
2299 BUTTE FALLS HWY |
| City | EAGLE POINT |
| State | OR |
| Zip Code | 97524-4463 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649630591 | Zane Smith | Pharmacist | 2299 Butte Falls Hwy, Eagle Point, OR 97524-4463 | 2016-03-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497373021 | Jennifer Schmidt | Psychologist | 995 Stonewater Dr., Eagle Point, OR 97524 | 2020-07-09 |
| 1639682834 | Marianne Arasmith | Massage Therapist | 6443 Monte Vista Ct, Eagle Point, OR 97524 | 2017-11-09 |
| 1437566163 | Mandy Dawn Walden | Behavioral Analyst | 360 N. Deanjou Ave, Eagle Point, OR 97524 | 2014-07-15 |
| 1710313200 | Casey Joe Winkler | Behavioral Analyst | 587 Sherman Way, Eagle Point, OR 97524 | 2013-09-17 |
| 1871745901 | Keith Fusao Ogawa | Dentist | 217 W. Main St., Eagle Point, OR 97524 | 2008-10-21 |
| 1578729893 | Tina Louise Matthews | Massage Therapist | 151 West Linn Rd, F6, Eagle Point, OR 97524 | 2008-08-06 |
| 1588700819 | Greg Gonzalez Pediatrics | Clinic/Center | 275 Loto Street, Eagle Point, OR 97524 | 2007-01-30 |
| 1194876235 | Donald Kirk Wolf | Physical Therapist | 158 Main, Eagle Point, OR 97524 | 2007-01-16 |
| 1780759985 | Eagle Point Dental Group,p.c. | Dentist | 217 W Main Street, Eagle Point, OR 97524 | 2006-11-22 |
| 1831268515 | Carmen D Edwards-henry | Speech-Language Pathologist | 1020 Highlands Drive, Eagle Point, OR 97524 | 2006-11-07 |
| Find all providers in zip 97524 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790059731 | Rogue Community Health | Clinic/Center | 203 N Platt Street, Eagle Point, OR 97524-0198 | 2012-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215540398 | La Clinica Del Valle Family Healthcare Center Inc. | Clinic/Center | 102 Christian Avenue, Talent, OR 97540 | 2020-08-28 |
| 1790398048 | La Clinica Del Valle Family Healthcare Center Inc. | Clinic/Center | 307 Wagner Creek Road, Talent, OR 97540 | 2020-08-26 |
| 1922656289 | Clackamas County | Clinic/Center | 39831 Highway 26, Sandy, OR 97055-6558 | 2019-08-29 |
| 1063067312 | Virginia Garcia Memorial Health Center | Clinic/Center | 11300 Sw Hazelbrook Rd, Tualatin, OR 97062-6980 | 2019-08-05 |
| 1417411505 | Klamath Health Partnership, Inc | Clinic/Center | 2210 N Eldorado Ave Ste A, Klamath Falls, OR 97601-6418 | 2019-01-23 |
| 1679053946 | Siskiyou Community Health Center Inc | Clinic/Center | 830 Ne 9th St, Grants Pass, OR 97526-1626 | 2018-08-16 |
| 1427563733 | Central City Concern Inc | Clinic/Center | 1415 Se 122nd Ave, Portland, OR 97233 | 2017-12-08 |
| 1598284242 | Winding Waters Medical Clinic | Clinic/Center | 401b N Main St, Joseph, OR 97846-5030 | 2017-09-13 |
| 1750807111 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 821 N Riverside Ave, Medford, OR 97501 | 2017-08-17 |
| 1477005619 | Outside In | Clinic/Center | 1226 Sw 12th Ave, Portland, OR 97205-2029 | 2016-11-03 |
| Find all providers with the same taxonomy | ||||
| City | EAGLE POINT |
| Zip Code | 97524 |
Please comment or provide details below to improve the information on WATERFALL COMMUNITY HEALTH CENTER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.