| Centennial Family Care Pc | |
|
7261 S Broadway Ste 101a Littleton CO 80122-8018 | |
| (303) 471-2466 | |
| (303) 471-6066 |
| Full Name | Centennial Family Care Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 7261 S Broadway Ste 101a, Littleton, Colorado |
| Authorized Official Name and Position | Angie Genevieve Poturalski (OWNER) |
| Authorized Official Contact | 3034712466 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centennial Family Care Pc 7261 S Broadway Ste 101a Littleton CO 80122-8018 Ph: (303) 471-2466 | Centennial Family Care Pc 7261 S Broadway Ste 101a Littleton CO 80122-8018 Ph: (303) 471-2466 |
| NPI Number | 1710348818 |
|---|---|
| Provider Enumeration Date | 03/16/2016 |
| Last Update Date | 03/16/2016 |
| Medicare PECOS PAC ID | 7719286301 |
|---|---|
| Medicare Enrollment ID | O20160503002192 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710348818 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | DR.0033806 (Colorado) | Primary |
| Provider Name | Angelique G Poturalski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144370545 PECOS PAC ID: 2860480951 Enrollment ID: I20040505001699 |
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