HARRISBURG MEDICAL CLINIC – NPI #1922458371
Clinic/Center

HARRISBURG MEDICAL CLINIC is an AHC clinic located in HARRISBURG, OR. NPPES has assigned the NPI number 1922458371 to HARRISBURG MEDICAL CLINIC on June 16, 2016. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “HARRISBURG MEDICAL CLINIC” is a dba name, the actual legal business name for this organization is ICCO LLC. This provider is also associated with 2 additional names listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QP2300X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Primary Care

The NPI profile was previously updated about 7 years ago on Jun 13, 2019. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for HARRISBURG MEDICAL CLINIC below.

NPI Profile for
ICCO LLC

NPI Number
1922458371
Enumeration Date

(about 10 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ICCO LLC
Doing Business As (dba): HARRISBURG MEDICAL CLINIC
Other name(s)
All associated names:
Doing Business As (dba)
HARRISBURG MEDICAL CLINIC
Doing Business As (dba)
Nova Health Harrisburg
Primary location
420 SMITH ST
HARRISBURG, OR 97446
Phone: (541) 995-5266 Fax: (541) 995-5245
Mailing address
1292 HIGH ST
SUITE 224
EUGENE, OR 97401-3238
Phone: (541) 641-6053 Fax: (541) 485-9987
Organization Subpart
No
Authorized Official
DOUGLAS BAILEY
MEDICAL DIRECTOR HARRISBURG CLINIC
Phone: (541) 998-6750
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QP2300X
- Clinic/Center / Primary Care (Primary)		 OR
261QU0200X
- Clinic/Center / Urgent Care		 OR

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.