Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rural Health |
261QR1300X | B4[14] | Rural Health Clinic | |
Primary Care |
261QP2300X |
| NPI Number | 1053452623 |
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| LBN Legal business name | NORTHWEST MEDICAL CENTER ASSOCIATION, INC | ||||
| Authorized official | DWIGHT CARVELL - (DIRECTOR OF REIMBURSEMENT) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | Yes | ||||
| Enumeration date | 02/08/2007 | ||||
| Last updated | 09/12/2024 - More than a year ago | ||||
| Identifiers |
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