| |
925 2nd Ave Monte Vista CO 81144-1432 | |
(719) 852-4533 | |
(719) 852-6134 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 925 2nd Ave, Monte Vista, Colorado |
Authorized Official Name and Position | Jania Arnoldi (PRESIDENT/CEO) |
Authorized Official Contact | 7195895161 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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128 Market St Alamosa CO 81101-2290 Ph: (719) 589-5161 | 925 2nd Ave Monte Vista CO 81144-1432 Ph: (719) 852-4533 |
NPI Number | 1629335583 |
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Provider Enumeration Date | 04/17/2012 |
Last Update Date | 02/04/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1629335583 | NPI | - | NPPES |
56836074 | Medicaid | CO | |
05638200 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Monte Vista Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 103 Chico Ct, Monte Vista, CO 81144 Phone: 719-852-9400 | |
Pence Pediatrics, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10 Rupert Street, West Entrance, Monte Vista, CO 81144 Phone: 719-852-3742 Fax: 719-785-5741 | |