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NPI Code Detail

MEDICARE: LIFESPAN FAMILY MEDICAL SERVICES

MEDICARE: LIFESPAN FAMILY MEDICAL SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2300XPrimary Care Clinic/Center105668CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285703652
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFESPAN FAMILY MEDICAL SERVICES
Provider Business Mailing Address
First Line : 320 W OLIVE ST
Second Line :
City : FORT COLLINS
State : CO
Zip : 80521-2716
Country : US
Telephone Number : 970-484-9533
Fax Number : 970-484-9544
Provider Business Practice Location Address
First Line : 320 W OLIVE ST
Second Line :
City : FORT COLLINS
State : CO
Zip : 80521-2716
Country : US
Telephone Number : 970-484-9533
Fax Number : 970-484-9544
Authorized Official
Title or Position : OWNER
Name : PAMELA PASTORE
Credential : FNP-BC
Telephone Number : 970-484-9533
Provider Enumeration Date : 11/07/2006
Last Update Date : 01/22/2010

Similar Medicare Providers

1649335654 — MS. LINDA TALARICO LCSW
Practice Location Address:
320 W OLIVE ST
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80521-2716
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1710140363 — MS. NICOLE RENEE MCGUIRE MA, LMHP, LPC
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Practice Fax:
1063733103 — MS. DENISE MARIE FLORES LMFT
Practice Location Address:
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1417299736 — MS. GENESA TARA FALCAO MA, LPC
Practice Location Address:
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1417386954 — MICHELLE E ABERNATHA LPC
Practice Location Address:
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Directions to “LIFESPAN FAMILY MEDICAL SERVICES ” Practice Location

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