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214 S 4th Street Kremmling CO 80459-0399 | |
(970) 724-3442 | |
(970) 887-5891 |
Full Name | |
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Speciality | Clinic/Center |
Location | 214 S 4th Street, Kremmling, Colorado |
Authorized Official Name and Position | Kelly Clasen (SR. DIRECTOR, BUSINESS OPERATION) |
Authorized Official Contact | 3076992413 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 399 Kremmling CO 80459-0399 Ph: (970) 724-3442 | 214 S 4th Street Kremmling CO 80459-0399 Ph: (970) 724-3442 |
NPI Number | 1174138903 |
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Provider Enumeration Date | 09/09/2020 |
Last Update Date | 01/25/2021 |
Medicare PECOS PAC ID | 7517871544 |
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Medicare Enrollment ID | O20180417002925 |
Identifier | Type | State | Issuer |
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1174138903 | NPI | - | NPPES |
04003281 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |