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405 Denver Avenue Saguache CO 81149 | |
(719) 530-2000 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 405 Denver Avenue, Saguache, Colorado |
Authorized Official Name and Position | Lesley Fagerberg (VICE PRESIDENT FINANCE) |
Authorized Official Contact | 7195302213 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 429 Salida CO 81201-0429 Ph: (719) 530-2213 | 405 Denver Avenue Saguache CO 81149 Ph: (719) 530-2000 |
NPI Number | 1356995237 |
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Provider Enumeration Date | 07/29/2019 |
Last Update Date | 06/30/2020 |
Medicare PECOS PAC ID | 3577451152 |
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Medicare Enrollment ID | O20191024000145 |
Identifier | Type | State | Issuer |
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1356995237 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |