| Radiant Healthcare Llc | |
|
1014 Elm Ave Rocky Ford CO 81067-1328 | |
| (719) 254-7421 | |
| Not Available |
| Full Name | Radiant Healthcare Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1014 Elm Ave, Rocky Ford, Colorado |
| Authorized Official Name and Position | Amanda Maxwell (OFFICE MANAGER) |
| Authorized Official Contact | 7192547421 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Radiant Healthcare Llc 1014 Elm Ave Rocky Ford CO 81067-1328 Ph: (719) 254-7421 | Radiant Healthcare Llc 1014 Elm Ave Rocky Ford CO 81067-1328 Ph: (719) 254-7421 |
| NPI Number | 1659003200 |
|---|---|
| Provider Enumeration Date | 06/30/2022 |
| Last Update Date | 02/01/2024 |
| Medicare PECOS PAC ID | 6406229038 |
|---|---|
| Medicare Enrollment ID | O20230302000695 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659003200 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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