| |
6301 W 38th Ave Wheat Ridge CO 80033-5057 | |
(303) 940-9118 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 6301 W 38th Ave, Wheat Ridge, Colorado |
Authorized Official Name and Position | Andrea Cortez (COO) |
Authorized Official Contact | 7208335099 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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3800 N York St Denver CO 80205-3540 Ph: (303) 296-1767 | 6301 W 38th Ave Wheat Ridge CO 80033-5057 Ph: (303) 940-9118 |
NPI Number | 1013491208 |
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Provider Enumeration Date | 09/24/2018 |
Last Update Date | 01/22/2024 |
Medicare PECOS PAC ID | 4688562697 |
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Medicare Enrollment ID | O20200211000515 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013491208 | NPI | - | NPPES |
4017372 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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