| High Plains Wiley Clinic | |
|
302 Main Wiley CO 81092 | |
| (719) 829-4286 | |
| (719) 829-4288 |
| Full Name | High Plains Wiley Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 302 Main, Wiley, Colorado |
| Authorized Official Name and Position | Robert Jay Brooke (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7193360261 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| High Plains Wiley Clinic 201 Kendall Dr Lamar CO 81052-3939 Ph: (719) 336-0261 | High Plains Wiley Clinic 302 Main Wiley CO 81092 Ph: (719) 829-4286 |
| NPI Number | 1912349465 |
|---|---|
| Provider Enumeration Date | 07/25/2013 |
| Last Update Date | 04/15/2014 |
| Medicare PECOS PAC ID | 8527031533 |
|---|---|
| Medicare Enrollment ID | O20140421000224 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912349465 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Wiley Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 302 Main St, Wiley, CO 81092 Phone: 719-829-4627 Fax: 719-829-4269 | |
Wiley Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 302 Main, Wiley, CO 81092 Phone: 719-829-4627 Fax: 719-829-4269 |