| Marillac Clinic, Inc. | |
|
2333 N 6th St Grand Junction CO 81501 | |
| (970) 298-1782 | |
| (970) 298-6314 |
| Full Name | Marillac Clinic, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2333 N 6th St, Grand Junction, Colorado |
| Authorized Official Name and Position | Lata Ramachandran (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9702982235 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marillac Clinic, Inc. 2333 N 6th St Grand Junction CO 81501-2001 Ph: (970) 298-2235 | Marillac Clinic, Inc. 2333 N 6th St Grand Junction CO 81501 Ph: (970) 298-1782 |
| NPI Number | 1518239219 |
|---|---|
| Provider Enumeration Date | 01/27/2012 |
| Last Update Date | 09/21/2020 |
| Medicare PECOS PAC ID | 1052634748 |
|---|---|
| Medicare Enrollment ID | O20150105001387 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518239219 | NPI | - | NPPES |
| 38402068 | Medicaid | CO | |
| 72071362 | Medicaid | CO | |
| 15522865 | Medicaid | CO | |
| 27421767 | Medicaid | CO | |
| 90252365 | Medicaid | CO | |
| 39400247 | Medicaid | CO |
| Provider Name | John W Whiteside |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679556427 PECOS PAC ID: 8729138250 Enrollment ID: I20090604000136 |
| Provider Name | James R Pasterz |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1598706640 PECOS PAC ID: 4688666183 Enrollment ID: I20100219000701 |
| Provider Name | Elizabeth Buisker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922262450 PECOS PAC ID: 8325174006 Enrollment ID: I20100406000036 |
| Provider Name | Kathy E Howe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700846318 PECOS PAC ID: 1658284856 Enrollment ID: I20101020001038 |
| Provider Name | April D Ross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487960092 PECOS PAC ID: 9830375385 Enrollment ID: I20110517000672 |
| Provider Name | Michael T Reeder |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003175878 PECOS PAC ID: 2466618053 Enrollment ID: I20120726000173 |
| Provider Name | Colleen Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568756237 PECOS PAC ID: 9638302599 Enrollment ID: I20140429001799 |
| Provider Name | Erica D Lovett Fournier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437220555 PECOS PAC ID: 4789612318 Enrollment ID: I20150428000211 |
| Provider Name | Stephen R Pyland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679710461 PECOS PAC ID: 1052331915 Enrollment ID: I20150521000111 |
| Provider Name | Roseanna M Jennings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801267133 PECOS PAC ID: 9133420425 Enrollment ID: I20151210000328 |
| Provider Name | Bradley Seago |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1578884094 PECOS PAC ID: 7719289255 Enrollment ID: I20151230001193 |
| Provider Name | Thomas J Lavery |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1265653505 PECOS PAC ID: 1850614553 Enrollment ID: I20160105000383 |
| Provider Name | Judd Chamberlain |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1194953133 PECOS PAC ID: 0648572404 Enrollment ID: I20160111001807 |
| Provider Name | Kathryn W Hart |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1871756304 PECOS PAC ID: 2567769177 Enrollment ID: I20160328000120 |
| Provider Name | Nikos P Hollis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083163612 PECOS PAC ID: 8527348564 Enrollment ID: I20161208000063 |
| Provider Name | Stephanie Sayers |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1609294982 PECOS PAC ID: 9335367747 Enrollment ID: I20170713000073 |
| Provider Name | Sherry Ann Woods |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972060002 PECOS PAC ID: 9537492178 Enrollment ID: I20190613000094 |
| Provider Name | Gretta Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306575170 PECOS PAC ID: 7517300064 Enrollment ID: I20240212002660 |
High Desert Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 132 Walnut Ave, Grand Junction, CO 81501 Phone: 970-245-1758 | |
Elevation Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1190 Bookcliff Ave Unit 101, Grand Junction, CO 81501 Phone: 970-245-2990 | |
James F Goggans Dmd Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2773 B 1/2 Rd, Ste A, Grand Junction, CO 81503 Phone: 970-257-1103 Fax: 970-257-7522 | |
Colorado Community Dental Services Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2795 Skyline Ct, Grand Junction, CO 81506 Phone: 970-242-3545 Fax: 970-254-9849 | |
Nyu Lutheran Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2333 N 6th St, Grand Junction, CO 81501 Phone: 970-255-1782 | |
Marillac Clinic, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 302 Pitkin Ave, Grand Junction, CO 81501 Phone: 970-298-1782 Fax: 970-298-1711 | |
Parkway Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1300 N 7th St, Grand Junction, CO 81501 Phone: 970-208-8046 |