| |
200 Robinson St Ste D300 Basalt CO 81621-8464 | |
(970) 476-1225 | |
Not Available |
Full Name | |
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Speciality | Durable Medical Equipment & Medical Supplies |
Location | 200 Robinson St Ste D300, Basalt, Colorado |
Authorized Official Name and Position | Michael G Brown (SVP & CFO) |
Authorized Official Contact | 9704797272 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 840220 Kansas City MO 64184-0220 Ph: (970) 777-2850 | 200 Robinson St Ste D300 Basalt CO 81621-8464 Ph: (970) 476-1225 |
NPI Number | 1215670625 |
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Provider Enumeration Date | 04/14/2022 |
Last Update Date | 01/09/2025 |
Medicare PECOS PAC ID | 3577475714 |
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Medicare Enrollment ID | O20220813000240 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215670625 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Primary |
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