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925 2nd Ave Monte Vista CO 81144-1432 | |
(719) 587-1001 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 925 2nd Ave, Monte Vista, Colorado |
Authorized Official Name and Position | Javier Martinez (CFO) |
Authorized Official Contact | 7195871083 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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128 Market St Alamosa CO 81101-2290 Ph: (719) 587-1001 | 925 2nd Ave Monte Vista CO 81144-1432 Ph: (719) 587-1001 |
NPI Number | 1952444523 |
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Provider Enumeration Date | 02/14/2007 |
Last Update Date | 05/13/2024 |
Medicare PECOS PAC ID | 5991609067 |
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Medicare Enrollment ID | O20240724003889 |
Identifier | Type | State | Issuer |
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1952444523 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | 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 | |