| Prairie View Clinic | |
|
615 W 5th N Cheyenne Wells CO 80810-0578 | |
| (719) 767-5669 | |
| Not Available |
| Full Name | Prairie View Clinic |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 615 W 5th N, Cheyenne Wells, Colorado |
| Authorized Official Name and Position | Charlene Korrell (CEO) |
| Authorized Official Contact | 7197675662 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prairie View Clinic Po Box 578 Cheyenne Wells CO 80810-0578 Ph: (719) 767-5661 | Prairie View Clinic 615 W 5th N Cheyenne Wells CO 80810-0578 Ph: (719) 767-5669 |
| NPI Number | 1003067349 |
|---|---|
| Provider Enumeration Date | 10/06/2008 |
| Last Update Date | 11/11/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003067349 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Prairie View Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 615 West 5th North, Cheyenne Wells, CO 80810 Phone: 719-767-5661 Fax: 719-767-8042 |