NPI 1063400968 · live from the CMS NPI Registry
Alder Medical Center PC
Family Medicine in Brookings, OR. National Provider Identifier 1063400968, active.
NPI record
| NPI | 1063400968 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine 207Q00000X |
| Practice location | 412 Alder St, Brookings, OR 97415 |
| Practice phone | 541-469-5919 |
| Mailing address | Po Box 5750, Brookings, OR 97415 |
| Enumerated | October 13, 2005 |
| Last updated | August 22, 2020 |
| Authorized official | Kelly Lowther, President |
| Other names | Alder Medical Center |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine primary | 207Q00000X | MD22599 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.