| Hydration Wellness Bar Llc | |
|
13530 Northgate Estates Dr Ste 110 Colorado Springs CO 80921-7651 | |
| (719) 358-6000 | |
| Not Available |
| Full Name | Hydration Wellness Bar Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 13530 Northgate Estates Dr Ste 110, Colorado Springs, Colorado |
| Authorized Official Name and Position | Jayme Oakley (NURSE PRACTITIONER) |
| Authorized Official Contact | 7209179149 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hydration Wellness Bar Llc 13530 Northgate Estates Dr Ste 110 Colorado Springs CO 80921-7651 Ph: (719) 358-6000 | Hydration Wellness Bar Llc 13530 Northgate Estates Dr Ste 110 Colorado Springs CO 80921-7651 Ph: (719) 358-6000 |
| NPI Number | 1508574443 |
|---|---|
| Provider Enumeration Date | 11/09/2022 |
| Last Update Date | 04/12/2023 |
| Medicare PECOS PAC ID | 8729443940 |
|---|---|
| Medicare Enrollment ID | O20230422000100 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508574443 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Jayme Oakley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528454428 PECOS PAC ID: 1951621754 Enrollment ID: I20150519001253 |
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