Healthcare Provider Details

I. General information

NPI: 1588955769
Provider Name (Legal Business Name): WELD COUNTY EMPLOYEE MEDICAL CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2011
Last Update Date: 04/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1551 N 17TH AVE STE 1
GREELEY CO
80631-9400
US

IV. Provider business mailing address

1551 N 17TH AVE STE 1
GREELEY CO
80631-9400
US

V. Phone/Fax

Practice location:
  • Phone: 970-304-6590
  • Fax: 970-304-6591
Mailing address:
  • Phone: 970-304-6590
  • Fax: 970-304-6591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1800X
TaxonomyCorporate Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROSE MARIE GRAINDA
Title or Position: CLINIC MANAGER
Credential: PA-C
Phone: 970-304-6590