| Big Thompson Medical Group Inc. | |
|
401 10th St Berthoud CO 80513-1381 | |
| (970) 532-4910 | |
| Not Available |
| Full Name | Big Thompson Medical Group Inc. |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 401 10th St, Berthoud, 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 |
|---|---|
| Big Thompson Medical Group Inc. 1441 N 12th St Phoenix AZ 85006-2837 Ph: () - | Big Thompson Medical Group Inc. 401 10th St Berthoud CO 80513-1381 Ph: (970) 532-4910 |
| NPI Number | 1396035184 |
|---|---|
| Provider Enumeration Date | 04/13/2011 |
| Last Update Date | 04/27/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396035184 | NPI | - | NPPES |
| 12408221 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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Banner Health Physicians Colorado Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 10th St, Berthoud, CO 80513 Phone: 970-532-4910 | |
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