| Western Medical Center Pc | |
|
1805 Kipling St Lakewood CO 80215 | |
| (303) 232-3232 | |
| (303) 232-3232 |
| Full Name | Western Medical Center Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1805 Kipling St, Lakewood, Colorado |
| Authorized Official Name and Position | Henry Manning Pickett (MEDICAL DIRECTOR STAFF PHYSICIAN) |
| Authorized Official Contact | 3032323232 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Western Medical Center Pc 1805 Kipling St Lakewood CO 80215 Ph: (303) 232-3232 | Western Medical Center Pc 1805 Kipling St Lakewood CO 80215 Ph: (303) 232-3232 |
| NPI Number | 1861691719 |
|---|---|
| Provider Enumeration Date | 07/12/2007 |
| Last Update Date | 07/12/2007 |
| Medicare PECOS PAC ID | 2365333077 |
|---|---|
| Medicare Enrollment ID | O20040323000340 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861691719 | NPI | - | NPPES |
| 04004966 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 18721 (Colorado) | Primary |
| Provider Name | H Manning Pickett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902964075 PECOS PAC ID: 6406949676 Enrollment ID: I20100831000841 |
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