Potomac Square Family Medicine, Llc is a
Clinic/center - Primary Care based in Boulder, Colorado. Potomac Square Family Medicine, Llc is licensed to practice in * (Not Available) (license number ) and their current practice location is
4800 Baseline Rd Ste D106, Boulder, Colorado. It can be reached at their office (for appointments etc.) via phone at
(303) 499-0176.
NPI number for Potomac Square Family Medicine, Llc is 1861001554 and their current mailing address is Po Box 173848, Denver, Colorado. Potomac Square Family Medicine, Llc
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1861001554.
Healthcare Provider's Profile
| Full Name | Potomac Square Family Medicine, Llc |
|---|
| Type | Facility |
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| Speciality | Clinic/center - Primary Care |
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| Location | 4800 Baseline Rd Ste D106, Boulder, Colorado |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1861001554
- Provider Enumeration Date: 07/28/2020
- Last Update Date: 04/14/2022
Medical Identifiers
Medical identifiers for Potomac Square Family Medicine, Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1861001554 | NPI | - | NPPES |
| 18903312 | Medicaid | CO | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Potomac Square Family Medicine, Llc is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Potomac Square Family Medicine, Llc
Po Box 173848,
Denver, CO 80217-3848
Ph: (303) 945-3299 | Potomac Square Family Medicine, Llc
4800 Baseline Rd Ste D106,
Boulder, CO 80303-2643
Ph: (303) 499-0176 |
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