| Lake City Area Medical Center | |
|
700 N Henson Lake City CO 81235-0999 | |
| (970) 944-2331 | |
| (970) 944-2320 |
| Full Name | Lake City Area Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 700 N Henson, Lake City, Colorado |
| Authorized Official Name and Position | Beuford T Durmon (MEDICAL DIRECTOR) |
| Authorized Official Contact | 9709442331 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake City Area Medical Center Po Box 999 Lake City CO 81235-0999 Ph: (970) 944-2331 | Lake City Area Medical Center 700 N Henson Lake City CO 81235-0999 Ph: (970) 944-2331 |
| NPI Number | 1790767192 |
|---|---|
| Provider Enumeration Date | 11/19/2005 |
| Last Update Date | 01/23/2017 |
| Medicare PECOS PAC ID | 4981513835 |
|---|---|
| Medicare Enrollment ID | O20030417000013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790767192 | NPI | - | NPPES |
| 66109019 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (Colorado) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (Colorado) | Primary |
Lake City Dental Clinic Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 700 North Henson St, Lake City, CO 81235 Phone: 970-944-2331 Fax: 970-944-2320 | |
Lake City Dental Clinic Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 700 N Henson St, Lake City, CO 81235 Phone: 970-944-2331 Fax: 970-944-2320 |