| |
310 Habitat Bay Windsor CO 80550-6130 | |
(970) 215-5000 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 310 Habitat Bay, Windsor, Colorado |
Authorized Official Name and Position | David C Jones (PRESIDENT) |
Authorized Official Contact | 8557555200 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 146 Windsor CO 80550-0146 Ph: (970) 215-5000 | 310 Habitat Bay Windsor CO 80550-6130 Ph: (970) 215-5000 |
NPI Number | 1356101042 |
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Provider Enumeration Date | 03/20/2024 |
Last Update Date | 01/01/2025 |
Certification Date | 01/01/2025 |
Medicare PECOS PAC ID | 7719410158 |
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Medicare Enrollment ID | O20241024000543 |
Identifier | Type | State | Issuer |
---|---|---|---|
1356101042 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
261QR0800X | Clinic/center - Recovery Care | (* (Not Available)) | Primary |
Provider Name | Gavin Parisi |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1437163813 PECOS PAC ID: 2961423280 Enrollment ID: I20241024000967 |
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