Community Health Clinic | |
495 W 4th St Dove Creek CO 81324-0576 | |
(970) 677-2291 | |
(970) 677-2540 |
Full Name | Community Health Clinic |
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Speciality | Clinic/Center |
Location | 495 W 4th St, Dove Creek, Colorado |
Authorized Official Name and Position | Dianne Smith (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 9706772291 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Community Health Clinic Po Box 576 Dove Creek CO 81324-0576 Ph: (970) 677-2291 | Community Health Clinic 495 W 4th St Dove Creek CO 81324-0576 Ph: (970) 677-2291 |
NPI Number | 1710954433 |
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Provider Enumeration Date | 03/01/2006 |
Last Update Date | 05/30/2012 |
Medicare PECOS PAC ID | 7517959877 |
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Medicare Enrollment ID | O20040330000970 |
Identifier | Type | State | Issuer |
---|---|---|---|
1710954433 | NPI | - | NPPES |
05682000 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 0589 (Colorado) | Primary |
Provider Name | Robert Tapley |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306091061 PECOS PAC ID: 6204972680 Enrollment ID: I20091015000510 |
Provider Name | Christie Sue Williams |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1306244017 PECOS PAC ID: 4789964263 Enrollment ID: I20161130000584 |
Provider Name | Terrill Kae Schmitt |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144736257 PECOS PAC ID: 6800151382 Enrollment ID: I20180604002779 |
Provider Name | Justin M Possner |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1689834046 PECOS PAC ID: 1658406038 Enrollment ID: I20180713000064 |
Axis Health System Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 495 W 4th St, Dove Creek, CO 81324 Phone: 970-677-2291 |