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NPI Code Detail

MEDICARE: PLATEAU VALLEY SKCHOOL DISTRICT 50

MEDICARE: PLATEAU VALLEY SKCHOOL DISTRICT 50
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
1251300000XLocal Education Agency (LEA)CO

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 : 1497824288
Entity Type Code : Organization
Provider Name (Legal Business Name) : PLATEAU VALLEY SKCHOOL DISTRICT 50
Provider Business Mailing Address
First Line : 56600 HIGHWAY 330
Second Line :
City : COLLBRAN
State : CO
Zip : 81624-9505
Country : US
Telephone Number : 970-487-3547
Fax Number : 970-245-0825
Provider Business Practice Location Address
First Line : 56600 HIGHWAY 330
Second Line :
City : COLLBRAN
State : CO
Zip : 81624-9505
Country : US
Telephone Number : 970-487-3547
Fax Number : 970-245-0825
Authorized Official
Title or Position : MEDICAID COORDINATOR
Name : DR. JUDITH D WICKER
Credential :
Telephone Number : 970-254-5308
Provider Enumeration Date : 11/07/2006
Last Update Date : 08/22/2020

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Directions to “PLATEAU VALLEY SKCHOOL DISTRICT 50 ” Practice Location

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