| Clinica Campesina Pecos | |
|
1701 W 72nd Ave Denver CO 80221-2721 | |
| (303) 650-4460 | |
| (303) 650-6830 |
| Full Name | Clinica Campesina Pecos |
|---|---|
| Speciality | Clinic/Center |
| Location | 1701 W 72nd Ave, Denver, Colorado |
| Authorized Official Name and Position | Simon Smith (CEO) |
| Authorized Official Contact | 3036653036 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinica Campesina Pecos 1735 S Public Rd Ste 203 Lafayette CO 80026-7093 Ph: (303) 665-3036 | Clinica Campesina Pecos 1701 W 72nd Ave Denver CO 80221-2721 Ph: (303) 650-4460 |
| NPI Number | 1548256522 |
|---|---|
| Provider Enumeration Date | 09/23/2005 |
| Last Update Date | 01/28/2019 |
| Medicare PECOS PAC ID | 7315850484 |
|---|---|
| Medicare Enrollment ID | O20060123000489 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548256522 | NPI | - | NPPES |
| 05638648 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 0556 (Colorado) | Primary |
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