| Banner Greeley Specialists | |
|
2410 W 16th St Greeley CO 80634-6004 | |
| (970) 352-6353 | |
| (970) 356-2264 |
| Full Name | Banner Greeley Specialists |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 2410 W 16th St, Greeley, Colorado |
| Authorized Official Name and Position | Dennis E Dahlen (SR VP FINANCE) |
| Authorized Official Contact | 6027474000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Banner Greeley Specialists 1441 N 12th St Phoenix AZ 85006-2837 Ph: () - | Banner Greeley Specialists 2410 W 16th St Greeley CO 80634-6004 Ph: (970) 352-6353 |
| NPI Number | 1649579673 |
|---|---|
| Provider Enumeration Date | 03/16/2011 |
| Last Update Date | 04/19/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649579673 | NPI | - | NPPES |
| 06600379 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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