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13099 County Rd G. Antonito CO 81120-9999 | |
(719) 376-7000 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 13099 County Rd G., Antonito, Colorado |
Authorized Official Name and Position | Javier Martinez (CFO) |
Authorized Official Contact | 7195871083 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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128 Market St Alamosa CO 81101-2290 Ph: (719) 587-1001 | 13099 County Rd G. Antonito CO 81120-9999 Ph: (719) 376-7000 |
NPI Number | 1770242323 |
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Provider Enumeration Date | 12/10/2021 |
Last Update Date | 05/13/2024 |
Identifier | Type | State | Issuer |
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1770242323 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Conejos County Hospital Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 315 Main Street, Antonito, CO 81120 Phone: 719-376-2308 Fax: 719-376-2395 | |