| Prairie View Clinic | |
|
615 West 5th North Cheyenne Wells CO 80810 | |
| (719) 767-5661 | |
| (719) 767-8042 |
| Full Name | Prairie View Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 615 West 5th North, Cheyenne Wells, Colorado |
| Authorized Official Name and Position | Mark Rossi (CEO) |
| Authorized Official Contact | 7197675661 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prairie View Clinic Po Box 578 Cheyenne Wells CO 80810-0578 Ph: (719) 767-5661 | Prairie View Clinic 615 West 5th North Cheyenne Wells CO 80810 Ph: (719) 767-5661 |
| NPI Number | 1396143574 |
|---|---|
| Provider Enumeration Date | 12/19/2014 |
| Last Update Date | 07/12/2022 |
| Medicare PECOS PAC ID | 8325364441 |
|---|---|
| Medicare Enrollment ID | O20150402000608 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396143574 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Prairie View Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 615 W 5th N, Cheyenne Wells, CO 80810 Phone: 719-767-5669 |