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350 Mckinley Street Walden CO 80480-9708 | |
(970) 723-4255 | |
(970) 723-4268 |
Full Name | |
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Speciality | Clinic/Center |
Location | 350 Mckinley Street, Walden, Colorado |
Authorized Official Name and Position | Kelly Clasen (SR. DIRECTOR, BUSINESS OPERATIONS) |
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) 724-3171 | 350 Mckinley Street Walden CO 80480-9708 Ph: (970) 723-4255 |
NPI Number | 1164064358 |
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Provider Enumeration Date | 10/09/2019 |
Last Update Date | 01/25/2021 |
Medicare PECOS PAC ID | 7517871544 |
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Medicare Enrollment ID | O20120301000819 |
Identifier | Type | State | Issuer |
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1164064358 | NPI | - | NPPES |
9000143431 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |