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General NPI Number Information
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NPI Number | 1699562116
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Entity Type | Organization
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Legal Business Name | PREMIER FAMILY MEDICINE AND MAT
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Dates
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Enumeration Date | 04/21/2025
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 2283 S MONACO ST PKWY SUIT 105
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City | DENVER
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State | CO
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Zip | 80222
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Country | US
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Telephone | 254-640-1718
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Fax |
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Provider Business Mailing Address
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Address Line | 2283 S MONACO ST PKWY SUIT 105
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City | DENVER
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State | CO
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Zip | 80222
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | JOYCE L LARSEN
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Credential |
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Telephone | 254-640-1718
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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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 | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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