| Vaxcare Colorado Llc | |
|
6005 Delmonico Dr Suite 150 Colorado Springs CO 80919-2237 | |
| (407) 480-5986 | |
| Not Available |
| Full Name | Vaxcare Colorado Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 6005 Delmonico Dr, Colorado Springs, Colorado |
| Authorized Official Name and Position | Casey Deloach (MANAGER) |
| Authorized Official Contact | 8888298550 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vaxcare Colorado Llc 3113 Lawton Rd Suite 250 Orlando FL 32803-3531 Ph: (407) 480-5986 | Vaxcare Colorado Llc 6005 Delmonico Dr Suite 150 Colorado Springs CO 80919-2237 Ph: (407) 480-5986 |
| NPI Number | 1164800082 |
|---|---|
| Provider Enumeration Date | 05/12/2015 |
| Last Update Date | 05/12/2015 |
| Medicare PECOS PAC ID | 7719213842 |
|---|---|
| Medicare Enrollment ID | O20190729000677 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164800082 | NPI | - | NPPES |
| PHC059 | Other | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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