Healthcare Provider Details

I. General information

NPI: 1033572615
Provider Name (Legal Business Name): AVON EMERGENCY AND URGENT CARE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2016
Last Update Date: 09/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 BUCK CREEK ROAD
AVON CO
81620
US

IV. Provider business mailing address

PO BOX 4450 DEPT 750
HOUSTON TX
77210-4450
US

V. Phone/Fax

Practice location:
  • Phone: 970-668-7000
  • Fax:
Mailing address:
  • Phone: 970-668-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KELLY LARKIN
Title or Position: CEO/OWNER
Credential: M.D.
Phone: 713-838-0800