ICCO LLC; NPI #1235672478

Contact Information

ICCO LLC

2710 WILLAMETTE STREET
EUGENE, OR 97405

Phone: 541-505-7317
Fax: 541-505-7486
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Primary Care	261QP2300X

Indicates primary specialty

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NPI Profile & details for ICCO LLC

NPI # 1235672478

LBN Legal business name ICCO LLC

Authorized official ERICA HAUSER - (CFO)

Entity Organization

Organization subpart ¹ No

Enumeration date 11/21/2016

Last updated 06/20/2022 - About 4 years ago

Identifiers

Other

DP1360

RR MEDICARE PTAN

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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