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General NPI Number Information
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NPI Number | 1033572615
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Entity Type | Organization
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Legal Business Name | AVON EMERGENCY AND URGENT CARE CENTER, LLC
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Dates
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Enumeration Date | 04/01/2016
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Last Update Date | 09/27/2016
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Provider Practice Location Address
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Address Line | 50 BUCK CREEK ROAD
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City | AVON
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State | CO
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Zip | 81620
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Country | US
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Telephone | 970-668-7000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4450 DEPT 750
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City | HOUSTON
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State | TX
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Zip | 77210-4450
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Country | US
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Telephone | 970-668-7000
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | KELLY LARKIN
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Credential | M.D.
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Telephone | 713-838-0800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number |
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License Number State |
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