| Millennium Regenerative Medicine, Inc. | |
|
175 E Main St Cedaredge CO 81413-3331 | |
| (970) 856-4729 | |
| Not Available |
| Full Name | Millennium Regenerative Medicine, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 175 E Main St, Cedaredge, Colorado |
| Authorized Official Name and Position | Timothy Hawbaker (OWNER) |
| Authorized Official Contact | 9708564729 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Millennium Regenerative Medicine, Inc. 235 Sw 8th Ave Cedaredge CO 81413-3902 Ph: () - | Millennium Regenerative Medicine, Inc. 175 E Main St Cedaredge CO 81413-3331 Ph: (970) 856-4729 |
| NPI Number | 1316429848 |
|---|---|
| Provider Enumeration Date | 08/31/2018 |
| Last Update Date | 01/15/2020 |
| Medicare PECOS PAC ID | 3072865500 |
|---|---|
| Medicare Enrollment ID | O20181011001586 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316429848 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Timothy P Hawbaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093849564 PECOS PAC ID: 8426355173 Enrollment ID: I20170131001862 |
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