MEDICARE: PROWERS MEDICAL CENTER

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	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1962684837
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROWERS MEDICAL CENTER

Provider Business Mailing Address
First Line	:	301 KENDALL DR
Second Line	:
City	:	LAMAR
State	:	CO
Zip	:	81052-3943
Country	:	US
Telephone Number	:	719-336-3179
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 KENDALL DR
Second Line	:
City	:	LAMAR
State	:	CO
Zip	:	81052-3943
Country	:	US
Telephone Number	:	719-336-3179
Fax Number	:

Authorized Official
Title or Position	:	PATIENT FINANCIAL SERVICES MANAGER
Name	:	MRS. KATHY F OSBORN
Credential	:
Telephone Number	:	719-336-5573

Provider Enumeration Date	:	12/03/2007
Last Update Date	:	12/03/2007

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Directions to “PROWERS MEDICAL CENTER ” Practice Location

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