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14833 S Rittgers St Eads CO 81036-9514 | |
(800) 511-5446 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 14833 S Rittgers St, Eads, Colorado |
Authorized Official Name and Position | Javier Martinez (CFO) |
Authorized Official Contact | 7195871083 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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128 Market St Alamosa CO 81101-2290 Ph: (719) 587-1001 | 14833 S Rittgers St Eads CO 81036-9514 Ph: (800) 511-5446 |
NPI Number | 1184339954 |
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Provider Enumeration Date | 01/17/2023 |
Last Update Date | 05/10/2024 |
Medicare PECOS PAC ID | 5991609067 |
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Medicare Enrollment ID | O20240131002610 |
Identifier | Type | State | Issuer |
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1184339954 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |