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NPI Code Detail

MEDICARE: CLINICA CAMPESINA FAMILY HEALTH SERVICES

MEDICARE: CLINICA CAMPESINA FAMILY HEALTH SERVICES
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
1261Q00000XClinic/Center0556CO

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 : 1225025406
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLINICA CAMPESINA FAMILY HEALTH SERVICES
Provider Business Mailing Address
First Line : 1735 S PUBLIC RD STE 203
Second Line :
City : LAFAYETTE
State : CO
Zip : 80026-7093
Country : US
Telephone Number : 303-665-3036
Fax Number : 303-665-9566
Provider Business Practice Location Address
First Line : 1735 S PUBLIC RD STE 201
Second Line :
City : LAFAYETTE
State : CO
Zip : 80026-7093
Country : US
Telephone Number : 303-665-3036
Fax Number : 303-665-9566
Authorized Official
Title or Position : CFO
Name : BRIAN J JOHNSTON
Credential :
Telephone Number : 303-926-0625
Provider Enumeration Date : 10/03/2005
Last Update Date : 07/13/2022

Similar Medicare Providers

1265393326 — MARAIS KIMMEL
Practice Location Address:
1735 S PUBLIC RD STE 100
LAFAYETTE, CO
80026-7093
Practice Phone: 303-650-4460
Practice Fax:
1831186915 — CLINICA CAMPESINA FAMILY HEALTH SERVICES
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1447248885 — KAREN ANNE FUNK MD
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1215925664 — MARY L. KARNER NP
Practice Location Address:
1735 S PUBLIC RD STE 100
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80026-7093
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Practice Fax: 303-665-3397
1669460010 — SUSAN J. MITCHELL NP
Practice Location Address:
1735 S PUBLIC RD STE 100
LAFAYETTE, CO
80026-7093
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1245228576 — CAROL DEBORAH SIEGEL FRIEFELD MD
Practice Location Address:
1735 S PUBLIC RD STE 100
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80026-7093
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Directions to “CLINICA CAMPESINA FAMILY HEALTH SERVICES ” Practice Location

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