ICCO, LLC
Clinic/Center (Rural Health)

Address: 186 W Ellendale Ave, Dallas, OR 97338-1408

ICCO, LLC (NPI# 1619558640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1619558640
Entity Type Organization
Organization Name ICCO, LLC
Practice Address 186 W Ellendale Ave
Dallas
OR 97338-1408
Practice Telephone 9719004984
Practice Fax Number 9719004977
Mailing Address Po Box 824
Springfield
OR 97477-0141
Mailing Telephone 5412283865
Certification Date 2021-04-20
Enumeration Date 2021-04-20
Last Update Date 2021-04-20
Authorized Official Telephone 3125905372
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification Taxonomy Group License Number License State Grouping
Y 261QR1300X Clinic/Center
Specialization: Rural Health
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Nova Health Doing Business As Name

Providers with the same name

NPI Name Taxonomy Address Enumeration
1104490887 Icco, LLC Clinic/Center - Rural Health 3400 Cooperative Way, Lebanon, OR 97355-4063 2021-05-17
1083159503 Icco, LLC · Prime Care Partners Veneta Clinic/Center 25045 Dunham Avenue, Veneta, OR 97487 2016-12-20
1407004757 Icco, LLC · Eugene Urgent Care Clinic/Center - Urgent Care 4040 W 11th Ave, Eugene, OR 97402-5601 2008-08-28
1194390385 Icco, LLC Clinic/Center - Rural Health 780 Nw Garden Valley Blvd Ste 310, Roseburg, OR 97471-2298 2021-05-21
1528641891 Icco, LLC Clinic/Center - Rural Health 1740 Nw Goetz St, Roseburg, OR 97471-1613 2021-05-04
1811570187 Icco, LLC Clinic/Center - Rural Health 1226 Virginia Ave, North Bend, OR 97459-2716 2021-05-04
1245810233 Icco, LLC Clinic/Center - Rural Health 87983 Territorial Hwy, Veneta, OR 97487 2021-04-13
1336725233 Icco, LLC Clinic/Center - Rural Health 1445 Gateway Blvd, Cottage Grove, OR 97424-1224 2021-03-22
1437660768 Icco, LLC · Musculoskeletal Clinic Family Medicine - Sports Medicine 598 E 13th Ave, Eugene, OR 97401-4783 2017-10-13
1285176867 Icco, LLC · Atlas Physical & Hand Therapy Physical Therapist 1800 Coburg Rd, Eugene, OR 97401-4995 2016-11-14
Find all providers with the same name

Office Location

Street Address 186 W ELLENDALE AVE
City DALLAS
State OR
Zip Code 97338-1408

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1063706273 Susan Zofchak Pharmacist 178 W Ellendale Ave, Dallas, OR 97338-1408 2011-06-06
1124304043 Dena Michelle Hollman Pharmacist 178 W Ellendale Ave, Dallas, OR 97338-1408 2011-10-24
1356824908 Sarah K Brattain Pharmacist - Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 138 W Ellendale Ave, Dallas, OR 97338-1408 2018-09-10
1891033247 David C Zandberg Pharmacist 138 W Ellendale Ave, Dallas, OR 97338-1408 2013-01-18
1942319223 Thrifty Payless Inc · Rite Aid Pharmacy 05368 Durable Medical Equipment & Medical Supplies 178 West Ellendale Avenue, Mill Valley Square, Dallas, OR 97338-1408 2006-08-30
1053357822 Safeway Inc · Safeway Pharmacy #4404 Durable Medical Equipment & Medical Supplies 138 W Ellendale Ave, Dallas, OR 97338-1408 2006-06-21
1447536412 John Mark Kangas Pharmacist 138 W Ellendale Ave, Dallas, OR 97338-1408 2011-10-22

Providers in the same zip code prefix

NPI Name Taxonomy Address Enumeration
1912116161 Nan Cecile Cordy Counselor - Mental Health 211 E. Ellendale Suite #7, Dallas, OR 97338 2007-05-22
1841615556 Leslie Lytle Counselor - Mental Health 1020 Sw Maple St., Dallas, OR 97338 2014-03-04
1013128560 Larry J Vuylsteke Social Worker 182 S.w. Academy, Dallas, OR 97338 2007-05-25
1588185953 Herbert Starr Woodward IIi Dentist - General Practice 201 Se Washington St, Dallas, OR 97338 2017-07-06
1235211343 Jennifer Lief Counselor - Addiction (Substance Use Disorder) 182 Sw Academy Street, Dallas, OR 97338 2006-10-19
1205265493 Chung-Fan Ni Counselor - Mental Health 182 S. W. Academy St., Academy Building, Dallas, OR 97338 2013-11-07
1740383116 Christopher David Johnson Optometrist 986 Se Uglow Street, Dallas, OR 97338 2006-09-07
1801932868 Eola Mental Health Services Counselor - Mental Health 2200 E Ellendale, Dallas, OR 97338 2007-01-29
1184633141 Clear Paths Inc Counselor - Addiction (Substance Use Disorder) 171 Sw Court, Dallas, OR 97338 2006-08-07
1215204300 Ron Fritz Counselor - Addiction (Substance Use Disorder) 239 E. Ellendale, Suite 602, Dallas, OR 97338 2011-11-17
Find all in zip 97338

Taxonomy Information

Taxonomy Code 261QR1300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rural Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1104490887 Icco, LLC Clinic/Center - Rural Health 3400 Cooperative Way, Lebanon, OR 97355-4063 2021-05-17
1336749621 Praxis Medical Group, Inc. Clinic/Center - Rural Health 2011 Fourth St., La Grande, OR 97850 2020-10-27
1386244689 Praxis Medical Group P.C. Clinic/Center - Rural Health 2474 Sw Perkins Ave, Pendleton, OR 97801 2020-10-27
1770183063 Praxis Medical Group, Inc. Clinic/Center - Rural Health 1890 7th St., Umatilla, OR 97882 2020-10-27
1093296519 Grande Ronde Hospital, Inc. · Grande Ronde Hospital Walk-In Clinic Clinic/Center - Rural Health 10303 S Walton Rd, La Grande, OR 97850 2018-08-23
1033698741 Columbia Lutheran Charities · Cmh Astoria Primary Care Clinic Clinic/Center - Rural Health 2158 Exchange St Ste 107, Astoria, OR 97103-3316 2018-08-13
1285164921 Northwest Medical Foundation of Tillamook · Adventist Health Tillamook Medical Group - Vernonia Clinic/Center - Rural Health 1005 Cougar St, Vernonia, OR 97064-1282 2017-06-15
1043740616 Northwest Medical Foundation of Tillamook · Adventist Health Tillamook Medical Group - Banks Clinic/Center - Rural Health 12350 Nw Main St Ste 112, Banks, OR 97106-9045 2017-06-15
1265806798 Rinehart Clinic Clinic/Center - Rural Health 278 Rowe Rd, Wheeler, OR 97147-0035 2015-11-20
1043694342 Grande Ronde Hospital, Inc · Grande Ronde Hospital Elgin Clinic Clinic/Center - Rural Health 570 8th, Elgin, OR 97827 2015-07-16
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Competitor

Search similar providers

City DALLAS
Zip Code 97338

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Dataset Information

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.