Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 123 Weeminuche, Ignacio, Colorado |
Authorized Official Name and Position | Linda C Winkler (MANAGER) |
Authorized Official Contact | 9705634742 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 737 Ignacio CO 81137-0737 Ph: (970) 563-4742 | 123 Weeminuche Ignacio CO 81137 Ph: (970) 563-4742 |
NPI Number | 1164881686 |
---|---|
Provider Enumeration Date | 02/11/2016 |
Last Update Date | 03/28/2016 |
Medicare PECOS PAC ID | 6800928292 |
---|---|
Medicare Enrollment ID | O20160331002427 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164881686 | NPI | - | NPPES |
18500323 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (Colorado) | Primary |