| |
1033 2nd Ave Monte Vista CO 81144-1737 | |
(719) 852-8827 | |
(719) 852-2739 |
Full Name | |
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Speciality | Clinic/center |
Location | 1033 2nd Ave, Monte Vista, Colorado |
Authorized Official Name and Position | Arlene Harms (CEO) |
Authorized Official Contact | 7196574104 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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310 County Road 14 Del Norte CO 81132-8719 Ph: (719) 657-2510 | 1033 2nd Ave Monte Vista CO 81144-1737 Ph: (719) 852-8827 |
NPI Number | 1265891667 |
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Provider Enumeration Date | 02/15/2016 |
Last Update Date | 04/05/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1265891667 | NPI | - | NPPES |
90871022 | Medicaid | CO | |
061301 | Other | CO | MEDICARE PART A |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 251011 (Colorado) | Primary |
Monte Vista Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 103 Chico Ct, Monte Vista, CO 81144 Phone: 719-852-9400 | |
Pence Pediatrics, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10 Rupert Street, West Entrance, Monte Vista, CO 81144 Phone: 719-852-3742 Fax: 719-785-5741 | |