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500 Nebraska Ave Stratton CO 80836-1366 | |
(719) 348-4650 | |
(719) 348-4653 |
Full Name | |
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Speciality | Clinic/Center |
Location | 500 Nebraska Ave, Stratton, Colorado |
Authorized Official Name and Position | Brenda L Briegel (MANAGER) |
Authorized Official Contact | 7193469481 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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500 Nebraska Ave Stratton CO 80836-1366 Ph: (719) 348-4650 | 500 Nebraska Ave Stratton CO 80836-1366 Ph: (719) 348-4650 |
NPI Number | 1124122403 |
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Provider Enumeration Date | 09/08/2006 |
Last Update Date | 02/23/2021 |
Medicare PECOS PAC ID | 4385637917 |
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Medicare Enrollment ID | O20080204000700 |
Identifier | Type | State | Issuer |
---|---|---|---|
1124122403 | NPI | - | NPPES |
41388330 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | 0905 (Colorado) | Primary |