MEDICARE: GREEN SPRINGS MEDICAL AND HEALTHCARE INC

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
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1962391631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREEN SPRINGS MEDICAL AND HEALTHCARE INC

Provider Business Mailing Address
First Line	:	19557 E 39TH AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80249-7347
Country	:	US
Telephone Number	:	720-387-1906
Fax Number	:

Provider Business Practice Location Address
First Line	:	19557 E 39TH AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80249-7347
Country	:	US
Telephone Number	:	720-387-1906
Fax Number	:

Authorized Official
Title or Position	:	CHIEF MEDICAL OFFICER
Name	:	ADESOJI OLUFIKAYO AJALA
Credential	:	NP
Telephone Number	:	720-400-2706

Provider Enumeration Date	:	06/30/2025
Last Update Date	:	06/30/2025

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