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1311a N Mildred Rd Cortez CO 81321-2231 | |
(970) 565-8556 | |
(970) 564-1134 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1311a N Mildred Rd, Cortez, Colorado |
Authorized Official Name and Position | Travis Parker (CHIEF HUMAN RESOURCES OFFICER) |
Authorized Official Contact | 9705642163 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1311 N Mildred Rd Cortez CO 81321-2231 Ph: (970) 564-2258 | 1311a N Mildred Rd Cortez CO 81321-2231 Ph: (970) 565-8556 |
NPI Number | 1578689527 |
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Provider Enumeration Date | 03/21/2007 |
Last Update Date | 06/20/2023 |
Medicare PECOS PAC ID | 5890699326 |
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Medicare Enrollment ID | O20071120000046 |
Identifier | Type | State | Issuer |
---|---|---|---|
1578689527 | NPI | - | NPPES |
00280585 | Medicaid | CO | |
1578689527 | Medicaid | UT | |
400943 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 0179 (Colorado) | Primary |
Southwest Internal Medicine Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 111 N Park St, Cortez, CO 81321 Phone: 970-564-8730 | |