Health Center At Jet Wing | |
1815 Jet Wing Dr Colorado Springs CO 80916-2300 | |
(719) 632-5700 | |
Not Available |
Full Name | Health Center At Jet Wing |
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Speciality | Clinic/Center |
Location | 1815 Jet Wing Dr, Colorado Springs, Colorado |
Authorized Official Name and Position | Ryan Spillane (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 7193447135 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Health Center At Jet Wing 3205 N Academy Blvd Ste 130 Colorado Springs CO 80917-5152 Ph: (719) 344-6873 | Health Center At Jet Wing 1815 Jet Wing Dr Colorado Springs CO 80916-2300 Ph: (719) 632-5700 |
NPI Number | 1437622206 |
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Provider Enumeration Date | 01/04/2019 |
Last Update Date | 03/06/2023 |
Medicare PECOS PAC ID | 4688583974 |
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Medicare Enrollment ID | O20190222000719 |
Identifier | Type | State | Issuer |
---|---|---|---|
1437622206 | NPI | - | NPPES |
05638267 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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