Healthcare Provider Details

I. General information

NPI: 1689404568
Provider Name (Legal Business Name): CEDAR POINT HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2024
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 SHERMAN ST
RIDGWAY CO
81432-8706
US

IV. Provider business mailing address

2303 S TOWNSEND AVE STE A
MONTROSE CO
81401-5452
US

V. Phone/Fax

Practice location:
  • Phone: 970-626-5123
  • Fax: 970-249-5029
Mailing address:
  • Phone: 970-249-7751
  • Fax: 970-249-5029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CORY PHILLIPS
Title or Position: CEO
Credential:
Phone: 970-249-7751