Penrose Family Health Clinic | |
91 Illinois St Penrose CO 81240-9683 | |
(719) 372-6555 | |
Not Available |
Full Name | Penrose Family Health Clinic |
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Speciality | Family Medicine |
Location | 91 Illinois St, Penrose, Colorado |
Authorized Official Name and Position | Madeleine Jacobs (SOLE PROPRIETOR) |
Authorized Official Contact | 7193726555 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Penrose Family Health Clinic 91 Illinois St Penrose CO 81240-9683 Ph: (719) 372-6555 | Penrose Family Health Clinic 91 Illinois St Penrose CO 81240-9683 Ph: (719) 372-6555 |
NPI Number | 1578910790 |
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Provider Enumeration Date | 05/17/2016 |
Last Update Date | 05/17/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1578910790 | NPI | - | NPPES |
01271006 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 27100 (Colorado) | Primary |