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660 N Bannock St Suite #1057 Denver CO 80204-4506 | |
| (303) 602-2822 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 660 N Bannock St, Denver, Colorado |
| Authorized Official Name and Position | April Audain (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 3036024965 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
777 Bannock St # Mc1923 Denver CO 80204-4507 Ph: (303) 436-6000 | 660 N Bannock St Suite #1057 Denver CO 80204-4506 Ph: (303) 602-2822 |
| NPI Number | 1184202897 |
|---|---|
| Provider Enumeration Date | 04/01/2021 |
| Last Update Date | 01/16/2025 |
| Medicare PECOS PAC ID | 2769893056 |
|---|---|
| Medicare Enrollment ID | O20210714001985 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184202897 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Primary |
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