| |
130 W 12th St Leadville CO 80461-3415 | |
(970) 668-4040 | |
Not Available |
Full Name | |
---|---|
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 130 W 12th St, Leadville, Colorado |
Authorized Official Name and Position | Josh Cogdill (CEO) |
Authorized Official Contact | 9706684040 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 4337 Frisco CO 80443-4337 Ph: (970) 668-4040 | 130 W 12th St Leadville CO 80461-3415 Ph: (970) 668-4040 |
NPI Number | 1245897008 |
---|---|
Provider Enumeration Date | 05/28/2019 |
Last Update Date | 12/30/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1245897008 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Rocky Mountain Family Practice Of Leadville Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 735 Us Highway 24, Leadville, CO 80461 Phone: 719-486-0500 Fax: 719-486-3966 |