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137 N Kansas St Walsh CO 81090-5060 | |
(719) 324-5253 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 137 N Kansas St, Walsh, Colorado |
Authorized Official Name and Position | Rita Hetrick (ADMINISTRATOR) |
Authorized Official Contact | 7193245262 |
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 206 Walsh CO 81090-0206 Ph: (719) 324-5262 | 137 N Kansas St Walsh CO 81090-5060 Ph: (719) 324-5253 |
NPI Number | 1588803050 |
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Provider Enumeration Date | 02/06/2009 |
Last Update Date | 12/19/2024 |
Medicare PECOS PAC ID | 4789576463 |
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Medicare Enrollment ID | O20090422000661 |
Identifier | Type | State | Issuer |
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1588803050 | NPI | - | NPPES |
86231871 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |