Rocky Ford Clinic | |
903 S 12th St Rocky Ford CO 81067-2127 | |
(719) 254-7623 | |
(719) 254-5112 |
Full Name | Rocky Ford Clinic |
---|---|
Speciality | Clinic/Center |
Location | 903 S 12th St, Rocky Ford, Colorado |
Authorized Official Name and Position | Jania Arnoldi (PRESIDENT/CEO) |
Authorized Official Contact | 7195895161 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Rocky Ford Clinic 128 Market St Alamosa CO 81101-2290 Ph: (719) 589-5161 | Rocky Ford Clinic 903 S 12th St Rocky Ford CO 81067-2127 Ph: (719) 254-7623 |
NPI Number | 1104813682 |
---|---|
Provider Enumeration Date | 09/30/2005 |
Last Update Date | 05/10/2024 |
Medicare PECOS PAC ID | 5991609067 |
---|---|
Medicare Enrollment ID | O20040105000527 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104813682 | NPI | - | NPPES |
CE 9669 | Other | CO | TRAVELERS MEDICARE NUMBER |
04280270 | Medicaid | CO | |
VAC 4808 | Other | CO | ANTHEM BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Colorado) | Primary |
Rocky Ford Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 903 S 12th St, Rocky Ford, CO 81067 Phone: 719-254-7623 Fax: 719-254-5112 |