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NPI Code Detail

MEDICARE: COUNTY OF FREMONT

MEDICARE: COUNTY OF FREMONT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1252Y00000XEarly Intervention Provider Agency
2251K00000XPublic Health or Welfare Agency

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2COB5228OTHERCOMEDICARE 73 MASS IMMUNIZATION ROSTER BILLER

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013917921
Entity Type Code : Organization
Provider Name (Legal Business Name) : COUNTY OF FREMONT
Provider Business Mailing Address
First Line : 201 N 6TH ST
Second Line :
City : CANON CITY
State : CO
Zip : 81212-3303
Country : US
Telephone Number : 719-276-7450
Fax Number : 719-276-7451
Provider Business Practice Location Address
First Line : 201 N 6TH ST
Second Line :
City : CANON CITY
State : CO
Zip : 81212-3303
Country : US
Telephone Number : 719-276-7450
Fax Number : 719-276-7451
Authorized Official
Title or Position : DIRECTOR
Name : MR. RICK A MIKLICH
Credential :
Telephone Number : 719-276-7449
Provider Enumeration Date : 07/21/2005
Last Update Date : 05/08/2017

Similar Medicare Providers

1598157828 — CRISTY LORE RN
Practice Location Address:
201 N 6TH ST
CANON CITY, CO
81212-3303
Practice Phone: 719-276-7458
Practice Fax:
1710379938 — PATRICIA SALLIE R.N.
Practice Location Address:
201 N 6TH ST
CANON CITY, CO
81212-3303
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Practice Fax: 719-276-7451
1720443989 — COLETTE TEXTOR RN
Practice Location Address:
201 N 6TH ST
CANON CITY, CO
81212-3303
Practice Phone: 719-276-7450
Practice Fax: 719-276-7451
1205386562 — BRITTANY BAGGETT RN
Practice Location Address:
201 N 6TH ST
CANON CITY, CO
81212-3303
Practice Phone: 719-276-7458
Practice Fax: 719-276-7451
1427584556 — FRANCIS COLLIER
Practice Location Address:
201 N 6TH ST
CANON CITY, CO
81212-3303
Practice Phone: 719-276-7457
Practice Fax:
1033633151 — ELIZABETH CRYSTAL CAROCHI
Practice Location Address:
201 N 6TH ST
CANON CITY, CO
81212-3303
Practice Phone: 719-276-7458
Practice Fax: 719-276-7451

Directions to “COUNTY OF FREMONT ” Practice Location

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