ICCO LLC (NPI# 1740896547) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740896547 |
| Entity Type | Organization |
| Organization Name | ICCO LLC |
| Practice Address |
4480 Highway 101 Ste G Florence OR 97439-8831 |
| Mailing Address |
Po Box 824 Springfield OR 97477-0141 |
| Practice Telephone | 4582152185 |
| Mailing Telephone | 5412283865 |
| Mailing Fax Number | 5416544693 |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2020-09-17 |
| Authorized Official Name | MRS. AMELIA D LEDBETTER (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 5733354715 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Nova Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922541184 | Icco LLC | Clinic/Center | 35859 Hwy 58, Pleasant Hill, OR 97455 | 2016-11-21 |
| 1639612880 | Icco LLC | Clinic/Center | 5781 Main Street, Springfield, OR 97478 | 2016-11-21 |
| 1053854208 | Icco LLC | Clinic/Center | 1740 Nw Goetz Street, Roseburg, OR 97471 | 2016-11-21 |
| 1235672478 | Icco LLC | Clinic/Center | 2710 Willamette Street, Eugene, OR 97405 | 2016-11-21 |
| 1922458371 | Icco LLC | Clinic/Center | 420 Smith St, Harrisburg, OR 97446 | 2016-06-16 |
| 1578928818 | Icco LLC | Clinic/Center | 1800 Coburg Road, Eugene, OR 97401 | 2015-12-30 |
| 1700251154 | Icco LLC | Physician Assistant | 1292 High Street, Suite 224, Eugene, OR 97401 | 2015-12-10 |
| 1649886441 | Icco LLC | Clinic/Center | 355 W 3rd Ave, Junction City, OR 97448-1313 | 2020-09-17 |
| 1063806842 | Icco LLC | Clinic/Center | 35859 Highway 58, Pleasant Hill, OR 97455-9651 | 2015-03-19 |
| 1821413881 | Icco LLC | Clinic/Center | 2710 Willamette St, Eugene, OR 97405-3238 | 2014-02-27 |
| Street Address |
4480 HIGHWAY 101 STE G |
| City | FLORENCE |
| State | OR |
| Zip Code | 97439-8831 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003874199 | Mildred Helen Rowley | Family Medicine | 4480 Highway 101 Ste G, Florence, OR 97439-8831 | 2006-05-01 |
| 1316289192 | Eric Dyer | Physician Assistant | 4480 Highway 101 Ste G, Florence, OR 97439-8831 | 2013-03-20 |
| 1548572589 | Anita Moghe | Physician Assistant | 4480 Highway 101 Ste G, Florence, OR 97439-8831 | 2010-07-07 |
| 1346452240 | Linda M Bono | Nurse Practitioner | 4480 Highway 101 Ste G, Florence, OR 97439-8831 | 2007-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417586488 | Kelcie-may S Toledo | Pharmacist | 700 Us-101, Florence, OR 97439 | 2020-04-02 |
| 1144875444 | Steven Mee | Dentist | 1225 Us - 101, Florence, OR 97439 | 2019-08-05 |
| 1164944351 | Karie James | Massage Therapist | 2010 11th St, Florence, OR 97439 | 2017-07-10 |
| 1205266046 | Deborah Lynne Grigsby | Counselor | 1490 1st Street, Unit #1, Florence, OR 97439 | 2013-11-14 |
| 1811247398 | Luke Henry | Occupational Therapist | 1951 East 21st Street, Florence, OR 97439 | 2012-09-12 |
| 1144589102 | Ryan Charles Korando | Denturist | 1705 22nd Street, Florence, OR 97439 | 2012-05-11 |
| 1568728640 | Deborah Lynn Pasternak | Massage Therapist | 1495 8th Street, Suite C, Florence, OR 97439 | 2012-04-03 |
| 1275844185 | Serena Appel | Counselor | 1525 12th St Ste 8, Florence, OR 97439 | 2010-06-24 |
| 1669702056 | Monarch Medical Group LLC | Clinic/Center | 2775 Hwy 101, Suite B, Florence, OR 97439 | 2010-01-06 |
| 1871722231 | Aen Brauer | Social Worker | 1445 W 8th St, Florence, OR 97439 | 2009-07-07 |
| Find all providers in zip 97439 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629318720 | Total Health Walk-in Clinic | Clinic/Center | 7377 Hwy 43, Florence, AL 35634-0000 | 2013-02-26 |
| 1356427843 | Simpson Community Healthcare, Inc | Clinic/Center | 1865 Simpson Highway 469, Florence, MS 39073-7430 | 2006-10-27 |
| 1700331006 | Ecm Health Group LLC | Clinic/Center | 11348 Highway 20, Florence, AL 35633-2702 | 2016-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770183063 | Praxis Medical Group P.C. | Clinic/Center | 1890 7th St., Umatilla, OR 97882 | 2020-10-27 |
| 1336749621 | Praxis Medical Group P.C. | Clinic/Center | 2011 Fourth St., La Grande, OR 97850 | 2020-10-27 |
| 1225694706 | Columbia Lutheran Charities | Clinic/Center | 1111 N Roosevelt Dr Ste 210, Seaside, OR 97138-4604 | 2019-05-10 |
| 1093296519 | Grande Ronde Hospital, Inc. | Clinic/Center | 10303 S Walton Rd, La Grande, OR 97850 | 2018-08-23 |
| 1285164921 | Northwest Medical Foundation of Tillamook | Clinic/Center | 1005 Cougar St, Vernonia, OR 97064-1282 | 2017-06-15 |
| 1043694342 | Grande Ronde Hospital, Inc | Clinic/Center | 570 8th, Elgin, OR 97827 | 2015-07-16 |
| 1992183859 | Centennial Medical Group East, LLC | Clinic/Center | 145 E. Broadway, Myrtle Creek, OR 97457 | 2015-05-12 |
| 1477945517 | Morrow County Health District | Clinic/Center | 365 W 3rd St, Ione, OR 97843-7216 | 2015-02-26 |
| 1699183236 | Lake Health District | Clinic/Center | 700 South J St, Lakeview, OR 97630 | 2014-07-28 |
| 1487919783 | Aurora Family Health and Maternity Care Services LLC | Clinic/Center | 21358 Hwy 99e Ne, Aurora, OR 97002 | 2012-07-12 |
| Find all providers with the same taxonomy | ||||
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| 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.