Slv Health La Jara Clinic | |
509 Main Street La Jara CO 81140 | |
(719) 274-5000 | |
(719) 274-4111 |
Full Name | Slv Health La Jara Clinic |
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Speciality | Clinic/Center |
Location | 509 Main Street, La Jara, Colorado |
Authorized Official Name and Position | Henry Garvin (CCH CEO) |
Authorized Official Contact | 7192746004 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Slv Health La Jara Clinic 19021 Us Highway 285 La Jara CO 81140-9410 Ph: (719) 274-5000 | Slv Health La Jara Clinic 509 Main Street La Jara CO 81140 Ph: (719) 274-5000 |
NPI Number | 1942511019 |
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Provider Enumeration Date | 06/23/2010 |
Last Update Date | 08/06/2013 |
Medicare PECOS PAC ID | 4789589094 |
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Medicare Enrollment ID | O20130812000167 |
Identifier | Type | State | Issuer |
---|---|---|---|
1942511019 | NPI | - | NPPES |
55601359 | Medicaid | CO | |
1376504092 | Other | CO | PREVIOUS NPI NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 011020 (Colorado) | Primary |
San Luis Valley Behavioral Health Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 322 Walnut Street, La Jara, CO 81140 Phone: 719-589-3671 | |
Conejos County Hospital Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 509 Main Street, La Jara, CO 81140 Phone: 719-274-5000 Fax: 719-274-4111 | |
San Luis Valley Behavioral Health Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 322 Walnut Street, La Jara, CO 81140 Phone: 719-589-3671 | |
C&g Health Care Management Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 39 Calle Miller, La Jara, CO 81140 Phone: 719-274-3311 |